Early improvement as a resilience signal predicting later remission to antidepressant treatment in patients with Major Depressive Disorder: Systematic review and meta-analysis.

Early improvement of depressive symptoms during the first two weeks of antidepressant treatment has been discussed to be a resilience signal predicting a later positive treatment outcome in patients with Major Depressive Disorder (MDD). However, the predictive value of early improvement varies between studies, and the use of different antidepressants may explain heterogeneous results. The objective of this review was to assess the predictive value of early improvement on later response and remission and to identify antidepressants with the highest chance of early improvement. We included 17 randomized controlled trials investigating early improvement in 14,779 adult patients with MDD compar…

Widerstandskraft im Alter: Mit Resilienz gesund alt werden

Resilienz als psychologisches Konzept ist die seelische Widerstandskraft zur Aufrechterhaltung oder Ruckgewinnung der psychischen Gesundheit wahrend oder nach widrigen Lebensumstanden. In der Resilienzforschung konzentrierte man sich lange auf die Erforschung der Entstehung und Behandlung von bereits vorliegenden Erkrankungen. Mit der Deklaration „Health for all“ (1978) der Weltgesundheitsorganisation und Antonovskys Konzept der Salutogenese (1979) vollzog sich ein grundlegender Perspektivenwechsel. Nicht nur die Frage, was den Menschen krank macht (Pathogenese), sondern insbesondere die Frage, was gesund halt (Salutogense) steht heute im Mittelpunkt der Arbeit. Die Resilienzforschung ist d…

S08-01 - Cochrane Reviews of Pharmacological and Psychological Interventions for Antisocial Personality Disorder (ASPD)

IntroductionASPD has a prevalence of 2-3% in the general population but rates in prison have been reported as 50% to 75%. ASPD is associated with significant psychiatric and medical comorbidity, high offending rates, poor psychosocial adaptation and premature death. Outcomes are poor. There is little consensus regarding the most effective intervention for the condition.Aims and objectivesTo conduct systematic literature reviews to identify randomised controlled trials for either pharmacological or psychological interventions for ASPD.MethodsSystematic literature reviews (Cochrane reviews).ResultsFor the review on psychological interventions only 11 studies could be included with a total of …

Pharmacological interventions for paranoid personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over three years due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn. To view the published versions of this article, please click the 'Other versions' tab.

Methylphenidate, modafinil, and caffeine for cognitive enhancement in chess: A double-blind, randomised controlled trial.

Stimulants and caffeine have been proposed for cognitive enhancement by healthy subjects. This study investigated whether performance in chess - a competitive mind game requiring highly complex cognitive skills - can be enhanced by methylphenidate, modafinil or caffeine. In a phase IV, randomized, double-blind, placebo-controlled trial, 39 male chess players received 2×200mg modafinil, 2×20mg methylphenidate, and 2×200mg caffeine or placebo in a 4×4 crossover design. They played twenty 15-minute games during two sessions against a chess program (Fritz 12; adapted to players' strength) and completed several neuropsychological tests. Marked substance effects were observed since all three subs…

Short-term Psychological Interventions for Bordeline Personality Disorder–What Works?

IntroductionBorderline personality disorder (BPD) is a common and disabling personality disorder associated with difficulties in controlling emotions and impulses, self-injury, feelings of emptiness and abandonment. It is associated with problems in many areas of life, most notably relationships. Psychotherapy is the first-line treatment for people with borderline personality disorder widely used; however, the evidence is not thoroughly investigated. In addition, several specific short-term interventions have been developed during the last decades.ObjectivesWe are currently updating this cochrane collaboration review on psychological interventions for BPD. First findings on the up-to-date e…

Muster des Missbrauchs von (Psycho-) Stimulanzien zum pharmakologischen Neuroenhancement bei Studierenden

Auch in Deutschland werden verschreibungspflichtige und illegale (Psycho-) Stimulanzien wie Methylphenidat und Amphetamine von Studierenden ohne medizinische Indikation zur geistigen Leistungssteigerung missbraucht. Uber die Charakteristika dieses sog. pharmakologischen Neuroenhancements (PN) ist bislang nur wenig bekannt. Semistrukturierte Interviews mit 20 Studierenden, die Stimulanzien zum PN eingenommen haben, uber Aspekte des PN (Motive, Einstellungen usw.). Es lassen sich 2 Muster des Substanzmissbrauchs zum PN unterscheiden, die zum Teil fliesend ineinander ubergehen und die exemplarisch anhand zweier Fallbeispiele dargestellt werden: Ein Muster ist charakterisiert durch transienten …

Increased CSF APPs-  levels in patients with Alzheimer disease treated with acitretin

Objective: We investigated induction of α-secretase A disintegrin and metalloprotease 10 (ADAM10) by the synthetic retinoid acitretin (Neotigason; Actavis, Munchen-Riem, Germany) in patients with mild to moderate Alzheimer disease (AD) via measurement of CSF content of α-secretase–derived amyloid precursor protein (APPs-α). Methods: Twenty-one patients clinically diagnosed with mild to moderate AD received acitretin (30 mg per day) or placebo in a 4-week double-blind study. Primary endpoint was the difference of CSF APPs-α ratios calculated from the APPs-α levels after treatment and at baseline. We monitored safety and tolerability of the treatment. In addition, we assessed biomarkers such …

Neural correlates of antinociception in borderline personality disorder.

Context A characteristic feature of borderline personality disorder (BPD) is self-injurious behavior in conjunction with stress-induced reduction of pain perception. Reduced pain sensitivity has been experimentally confirmed in patients with BPD, but the neural correlates of antinociceptive mechanisms in BPD are unknown. We predicted that heat stimuli in patients with BPD would activate brain areas concerned with cognitive and emotional evaluation of pain. Objective To assess the psychophysical properties and neural correlates of altered pain processing in patients with BPD. Design Case-control study. Setting A university hospital. Participants Twelve women with BPD and self-injurious behav…

Psychological interventions for obsessive-compulsive personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over three years due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn. To view the published versions of this article, please click the 'Other versions' tab.

Corrigendum to "Intervention studies to foster resilience - A systematic review and proposal for a resilience framework in future intervention studies" [Clinical Psychology Review 59 (2018) 78-100].

Charakteristika von Studierenden, die pharmakologisches Neuroenhancement mit Stimulanzien betreiben: Eine Pilotstudie

Anliegen: Charakterisierung deutscher Studenten, die Methylphenidat (MPH) und/oder Amphetamine (AMPH) zum pharmakologischen Neuroenhancement (PN) konsumieren. Methode: Semistrukturierte Interviews mit 20 Konsumenten und 20 Kontrollprobanden. Ergebnisse: Die Konsumenten waren besser uber die Moglichkeit der Einnahme illegaler Substanzen zum PN informiert als die Kontrollgruppe. AMPH-Konsumenten nahmen haufiger weitere illegale Substanzen zum PN ein als MPH-Konsumenten, wahrend hinsichtlich legaler Substanzen zum PN kein Unterschied zwischen den beiden Konsumentengruppen bestand. AMPH-Konsumenten hatten AMPH vornehmlich nasal eingenommen. Insgesamt wiesen die Stimulanzienkonsumenten haufiger …

Early onset of depression and treatment outcome in patients with major depressive disorder

Major depressive disorder (MDD) is a highly heterogeneous disorder, which may partly explain why treatment outcome using antidepressants is unsatisfactory. We investigated the onset of depression as a possible clinical marker for therapy response prediction in the context of somatic biomarkers blood pressure and plasma electrolyte concentration. 889 MDD patients were divided into early (EO, n = 226), intermediate (IO, n = 493), and late onset (LO, n = 169) patients and were analyzed for differences in socio-demographic and clinical parameters, comorbidities and treatment outcome as well as systolic blood pressure and electrolytes. EO patients more often suffered from a recurrent depression,…

Corrigendum to ‘State dependent posterior hippocampal volume increases in patients with major depressive disorder’ [J. Affect. Disord. 135 (1–3) (2011) 405–409]

Differential effects of age on subcomponents of response inhibition.

Inhibitory deficits contribute to cognitive decline in the aging brain. Separating subcomponents of response inhibition may help to resolve contradictions in the existing literature. A total of 49 healthy participants underwent functional magnetic resonance imaging (fMRI) while performing a Go/no-go-, a Simon-, and a Stop-signal task. Regression analyses were conducted to identify correlations of age and activation patterns. Imaging results revealed a differential effect of age on subcomponents of response inhibition. In a simple Go/no-go task (no spatial discrimination), aging was associated with increased activation of the core inhibitory network and parietal areas. In the Simon task, whi…

Declaration and Handling of Conflicts of Interest in Guidelines

Clinical guidelines are developed in order to support physicians and patients in specific clinical situations when decisions concerning diagnosis and treatment are made. Recommendations provided in guidelines are based on the findings of clinical studies and on expert opinion. Identical study findings may be evaluated differently depending on whether or not guideline authors have conflicts of interest (1). A conflict of interest is defined as a circumstance that gives rise to a risk that professional judgement or actions concerning a primary interest may be inappropriately influenced by a secondary interest (2, 3). A conflict of interest is therefore a state of affairs, not a biased evaluat…

Is pharmacotherapy useful for treating personality disorders?

Personality disorders are characterized by enduring maladaptive patterns of behavior, cognition, and inner experience exhibited across many contexts and deviating from those accepted by the individ...

Differential associations of leisure music engagement with resilience : A network analysis

Background/Objective Several factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement. Method 511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listenin…

The frequent stressor and mental health monitoring-paradigm: a proposal for the operationalization and measurement of resilience and the identification of resilience processes in longitudinal observational studies

Resilience has been defined as the maintenance or quick recovery of mental health during and after times of adversity. How to operationalize resilience and to determine the factors and processes that lead to good long-term mental health outcomes in stressor-exposed individuals is a matter of ongoing debate and of critical importance for the advancement of the field. One of the biggest challenges for implementing an outcome-based definition of resilience in longitudinal observational study designs lies in the fact that real-life adversity is usually unpredictable and that its substantial qualitative as well as temporal variability between subjects often precludes defining circumscribed time …

Impact of physicians’ participation in non-interventional post-marketing studies on their prescription habits: A retrospective 2-armed cohort study in Germany

Background Non-interventional post-marketing studies (NIPMSs) sponsored by pharmaceutical companies are controversial because, while they are theoretically useful instruments for pharmacovigilance, some authors have hypothesized that they are merely marketing instruments used to influence physicians’ prescription behavior. So far, it has not been shown, to our knowledge, whether NIPMSs actually do have an influence on prescription behavior. The objective of this study was therefore to investigate whether physicians’ participation in NIPMSs initiated by pharmaceutical companies has an impact on their prescription behavior. In addition, we wanted to analyze whether specific characteristics of…

Data-driven analysis of simultaneous EEG/fMRI reveals neurophysiological phenotypes of impulse control

Response inhibition is the ability to suppress inadequate but prepotent or ongoing response tendencies. A fronto-striatal network is involved in these processes. Between-subject differences in the intra-individual variability have been suggested to constitute a key to pathological processes underlying impulse control disorders. Single-trial EEG/fMRI analysis allows to increase sensitivity for inter-individual differences by incorporating intra-individual variability. Thirty-eight healthy subjects performed a visual Go/Nogo task during simultaneous EEG/fMRI. Of 38 healthy subjects, 21 subjects reliably showed Nogo-related ICs (Nogo-IC-positive) while 17 subjects (Nogo-IC-negative) did not. C…

Differential impact of COVID-related lockdown on mental health in Germany.

Einstellungen und Erwartungen von Patienten in Bezug auf Interessenkonflikte ihrer behandelnden Ärzte

Zusammenfassung Hintergrund Patienten durfen zu Recht erwarten, dass im Vertrauensverhaltnis zu ihrem Arzt sekundare Interessen keine unangemessene Rolle spielen. Was Patienten uber Interessenkonflikte ihrer Arzte durch die Zusammenarbeit mit pharmazeutischen Unternehmern wissen und ob und wie sie daruber informiert werden wollen, ist in Deutschland wenig bekannt. Methode 765 Patienten in verschiedenen Arztpraxen und Kliniken (Ambulanzen und Stationen) zweier deutscher Stadte erhielten ein Informationsblatt zu Interessenkonflikten und einen Fragebogen mit 19 Fragen. 80% (n = 612) der Fragebogen wurden anonym ausgefullt abgegeben. Ergebnisse 65% der Patienten waren keine moglichen Interessen…

Effects of age on depressive symptomatology and response to antidepressant treatment in patients with major depressive disorder aged 18 to 65 years

Background: There is evidence that symptomatology in patients with major depressive disorder (MDD) changes with age. However, studies comparing depressive symptomatology between different age groups during antidepressant therapy are rare. We compared demographic and clinical characteristics in depressed patients of different age groups at baseline and during treatment. Methods: 889 MDD inpatients were divided into four age groups (18–29, 30–39, 40–49, 50–65 yrs.). Demographic and clinical characteristics including depressive symptomatology (assessed by the Inventory of Depressive Symptoms) were assessed at baseline and weekly during treatment. Results: At baseline, young patients (18–29 yea…

Neural Architecture of Selective Stopping Strategies: Distinct Brain Activity Patterns Are Associated with Attentional Capture But Not with Outright Stopping

In stimulus-selective stop-signal tasks, the salient stop signal needs attentional processing before genuine response inhibition is completed. Differential prefrontal involvement in attentional capture and response inhibition has been linked to the right inferior frontal junction (IFJ) and ventrolateral prefrontal cortex (VLPFC), respectively. Recently, it has been suggested that stimulus-selective stopping may be accomplished by the following different strategies: individuals may selectively inhibit their response only upon detecting a stop signal (independent discriminate then stop strategy) or unselectively whenever detecting a stop or attentional capture signal (stop then discriminate s…

WITHDRAWN: Association analysis between the early change of serum brain-derived neurotrophic factor (sBDNF) and final change of depression severity during antidepressant treatment: A pilot study.

This article has been withdrawn at the request of the Editor-in-Chief. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.

Von der symptomatischen zur kausalen Therapie?

Until today the pharmacological therapy of Alzheimer’s disease (AD) is still limited to symptomatic temporary improvement or stabilization of cognitive performance and activities of daily living, and the reduction of neuropsychiatric symptoms of the disease. Available symptomatic treatment options are the acetylcholinesterase inhibitors (ACh-I) donepezil, galantamine, rivastigmine, and the partial N-Methyl-D-Aspartat-(NMDA)-antagonist memantine. Further substances with symptomatic targets, especially selective acetylcholine and histamine receptors, are currently under development. Numerous of disease-modifying substances mainly targeting components of the amyloidogenic pathway of AD are pre…

Randomized controlled study of early medication change for non-improvers to antidepressant therapy in major depression – The EMC trial

Patients with Major Depressive Disorder (MDD) and no improvement after two weeks of antidepressant pharmacotherapy have a high risk of treatment failure. The aim of the study was to determine whether an early medication change (EMC) strategy is superior to a guideline-based treatment in MDD patients without improvement after two weeks of antidepressant pharmacotherapy. Eight-hundred-and-eighty-nine patients with MDD were enrolled, 879 patients received the SSRI escitalopram. Of those, 192 patients had no improvement, defined as a reduction of < 20% on the Hamilton Depression Rating Scale (HAMD-17) after 14 days of treatment, and were randomly assigned to open treatment with the EMC strategy…

Life context of pharmacological academic performance enhancement among university students – a qualitative approach

Background Academic performance enhancement or cognitive enhancement (CE) via stimulant drug use has received increasing attention. The question remains, however, whether CE solely represents the use of drugs for achieving better academic or workplace results or whether CE also serves various other purposes. The aim of this study was to put the phenomenon of pharmacological academic performance enhancement via prescription and illicit (psycho-) stimulant use (Amphetamines, Methylphenidate) among university students into a broader context. Specifically, we wanted to further understand students’ experiences, the effects of use on students and other factors, such as pressure to perform in thei…

W05-01 - Rationale and Design of an RCT Comparing “EMC-Strategy” with TAU in Patients with Major Depression - the EMC Trial

IntroductionFor Major Depression, current guidelines recommend treatment durations of 3-8 weeks until optimisation in case of insufficient outcome. Many retrospective studies indicate that improvement (HAMD-17 decrease ≥20%) occurs usually within 10-14 days and that non-improvement after 14 days of treatment is highly predictive for poor clinical outcome.MethodsIn level 1 of the EMC trial, non-improvers after 14 days of antidepressant treatment will be randomised to “early medication change” (EMC) strategy or treatment according to current guidelines (TAU). EMC schedules treatment optimisations on day 15 and day 29 in case of non-improvement. TAU schedules a medication change after 28 days …

Modulatory role of the brain-derived neurotrophic factor Val66Met polymorphism on the effects of serious life events on impulsive aggression in borderline personality disorder.

Impulsive aggression belongs to the key features of borderline personality disorder (BPD). In the development of BPD, serious life events are known to play a major role. Acute and chronic stress has been suggested to inhibit hippocampal brain-derived neurotrophic factor (BDNF) synthesis and to mediate neural plasticity in response to adverse social experiences. Recently it has been reported that the frequency of violent suicide attempts is higher in adult suicide attempters reporting severe childhood sexual abuse and carrying the Val(66)Val genotype of the BDNF Val(66)Met polymorphism. In this study we analysed modulating effects of BDNF Val(66)Met polymorphism on the effects of physical ma…

Right inferior frontal gyrus implements motor inhibitory control via beta-band oscillations in humans

Motor inhibitory control implemented as response inhibition is an essential cognitive function required to dynamically adapt to rapidly changing environments. Despite over a decade of research on the neural mechanisms of response inhibition, it remains unclear, how exactly response inhibition is initiated and implemented. Using a multimodal MEG/fMRI approach in 59 subjects, our results reliably reveal that response inhibition is initiated by the right inferior frontal gyrus (rIFG) as a form of attention-independent top-down control that involves the modulation of beta-band activity. Furthermore, stopping performance was predicted by beta-band power, and beta-band connectivity was directed f…

Individual participant data systematic reviews with meta-analyses of psychotherapies for borderline personality disorder

IntroductionThe heterogeneity in people with borderline personality disorder (BPD) and the range of specialised psychotherapies means that people with certain BPD characteristics might benefit more or less from different types of psychotherapy. Identifying moderating characteristics of individuals is a key to refine and tailor standard treatments so they match the specificities of the individual participant. The objective of this is to improve the quality of care and the individual outcomes. We will do so by performing three systematic reviews with meta-analyses of individual participant data (IPD). The aim of these reviews is to investigate potential predictors and moderating patient chara…

P01-92 - Early Changes are Associated with late Changes of BDNF Serum Levels in Inpatients with Major Depression During Short-term Antidepressant Treatment

ObjectivesMean BDNF serum concentration is lower in patients with major depression (MD) as compared to healthy controls. BDNF increases during the course of antidepressant treatment. This increase has been associated with symptom amelioration. The aim of this study was to analyse the relation between early and late BDNF changes during antidepressant treatment.MethodsForty-six patients with MD according to DSM-IV were included for this study. Patients were treated as clinically indicated. Depression severity was assessed by HAMD-17 by trained raters from baseline to week 6 in weekly intervals. Serum at each visit (baseline, V1-V6) was obtained from whole blood after centrifugation with 1.000…

Störungsorientierte, evidenzbasierte Psychotherapieverfahren am Beispiel der Borderline-Persönlichkeitsstörung

Die Behandlung psychischer Storungen mittels Psychotherapie hat sich in den beiden letzten Jahrzehnten kontinuierlich hin zu storungsorientierten, evidenzbasierten Verfahren entwickelt und zumindest im wissenschaftlichen Bereich das Denken in Psychotherapieschulen abgelost. Diese neuen Entwicklungen werden anhand der storungszentrierten und evidenzbasierten psychotherapeutischen Behandlungsverfahren der Borderline-Personlichkeitsstorung nachvollzogen und diskutiert. Aus den Erfahrungen in der Psychotherapieforschung zu Personlichkeitsstorungen werden programmatische Empfehlungen zur zukunftigen Weiterentwicklung der Psychotherapieforschung und der Finanzierung von Psychotherapie gegeben.

Non‐Pharmacologic Multicomponent Interventions Preventing Delirium in Hospitalized People

BACKGROUND/OBJECTIVES Delirium is a common neurobehavioral complication in hospitalized patients with a high prevalence in various clinical settings. Prevention of delirium is critical due to its common occurrence and associated poor outcomes. Our objective was to evaluate the efficacy of multicomponent interventions in preventing incident delirium in hospitalized patients at risk. DESIGN Systematic review and meta-analysis. SETTING Hospital. PARTICIPANTS We included a study if it was a randomized controlled trial and was evaluating effects of coordinated non-pharmacologic multicomponent interventions in the prevention of delirium. MEASUREMENTS We performed a systematic literature search in…

Cortical network mechanisms of response inhibition

SummaryBoth the right inferior frontal gyrus (rIFG) and the pre-supplementary motor area (pre-SMA) are crucial for successful response inhibition. However, the particular functional roles of those two regions have been controversially debated for more than a decade now. It is unclear whether the rIFG directly initiates stopping or serves an attentional function, whereas the stopping is triggered by the pre-SMA. The current multimodal MEG/fMRI study sought to clarify the role and temporal activation order of both regions in response inhibition using a selective stopping task. This task dissociates inhibitory from attentional processes. Our results reliably reveal a temporal precedence of rIF…

Pharmacological interventions for schizoid personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over three years due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn. To view the published versions of this article, please click the 'Other versions' tab.

Early life stress stimulates hippocampal reelin gene expression in a sex-specific manner: Evidence for corticosterone-mediated action

Early life stress predisposes to the development of psychiatric disorders. In this context the hippocampal formation is of particular interest, because it is affected by stress on the structural and cognitive level. Since little is known how early life stress is translated on the molecular level, we mimicked early life stress in mouse models and analyzed the expression of the glycoprotein Reelin, a master molecule for development and differentiation of the hippocampus. From postnatal day 1 (P1) to P14, mouse pups were subjected to one of the following treatments: nonhandling (NH), handling (H), maternal separation (MS), and early deprivation (ED) followed by immediate (P15) or delayed (P70)…

Acute effect of intravenously applied alcohol in the human striatal and extrastriatal D2 /D3 dopamine system

Investigations on the acute effects of alcohol in the human mesolimbic dopamine D2 /D3 receptor system have yielded conflicting results. With respect to the effects of alcohol on extrastriatal D2 /D3 dopamine receptors no investigations have been reported yet. Therefore we applied PET imaging using the postsynaptic dopamine D2 /D3 receptor ligand [18 F]fallypride addressing the question, whether intravenously applied alcohol stimulates the extrastriatal and striatal dopamine system. We measured subjective effects of alcohol and made correlation analyses with the striatal and extrastriatal D2 /D3 binding potential. Twenty-four healthy male μ-opioid receptor (OPRM1)118G allele carriers underw…

Group Therapy Module to Enhance Self-Esteem in Patients with Borderline Personality Disorder: A Pilot Study

Psychotherapeutic treatments of borderline personality disorder (BPD) often focus on severe behavioral problems. Until now, few techniques have been developed to specifically address low self-esteem in BPD. We developed a 6-session psychoeducative group therapy module to treat low self-esteem in BPD patients. After developing and piloting the therapy module, a controlled outpatient pilot study was performed. Nineteen female BPD patients participated in the group module after discharge from an inpatient DBT program. Twenty-four female BPD patients served as controls. Outcome was assessed by different self-esteem measures. Results showed a greater improvement in self-esteem in the interventio…

Author response: Right inferior frontal gyrus implements motor inhibitory control via beta-band oscillations in humans

Lack of modulating effects of the COMT Val158Met polymorphism on the association of serious life events (SLE) and impulsivity in patients with Borderline Personality Disorder

Pharmacological interventions for avoidant personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over two years due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn. To view the published versions of this article, please click the 'Other versions' tab.

World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of personality disorders.

These practical guidelines for the biological treatment of personality disorders in primary care settings were developed by an international Task Force of the World Federation of Societies of Biological Psychiatry (WFSBP). They embody the results of a systematic review of all available clinical and scientific evidence pertaining to the biological treatment of three specific personality disorders, namely borderline, schizotypal and anxious/avoidant personality disorder in addition to some general recommendations for the whole field. The guidelines cover disease definition, classification, epidemiology, course and current knowledge on biological underpinnings, and provide a detailed overview …

State dependent posterior hippocampal volume increases in patients with major depressive disorder.

Abstract Background The hippocampal formation has been implicated in etiology and therapy response in major depressive disorder (MDD). However, prospective longitudinal studies investigating volumes in hippocampal subregions and their association with clinical findings are still lacking. Methods Global and regional hippocampal volumes and neuropsychological performance were assessed longitudinally in 15 young patients with unipolar early onset MDD who responded to therapy and 13 matched healthy control subjects. Results Although volumes at baseline did not differ between groups, patients with MDD showed significant posterior hippocampal volume increases during the treatment course (mean obs…

Psychological interventions for resilience enhancement in adults

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of resilience‐enhancing interventions in clinical and non‐clinical populations.

Pharmacological Neuroenhancement, Perceived Stress, and Resilience in Spine Surgeons–A Cross-Sectional Survey

Background Spine surgeons are usually exposed to high workload and demanding work conditions. Although the relationship between pharmacological neuroenhancement (PNE) and resilience (i.e., the ability to recover from stress), as well as perceived stress and resilience-enhancing factors, has been investigated in the general population, less is known about the impact of those factors in spine surgeons. This study aimed to close that gap by investigating the relationship between PNE use and resilience, perceived stress, or resilience-enhancing factors in spine surgeons. Methods We conducted a cross-sectional survey in a sample of 582 spine surgeons in German-speaking countries (Austria, German…

A combined marker of early non-improvement and the occurrence of melancholic features improve the treatment prediction in patients with Major Depressive Disorders

Abstract Background Early Improvement of depressive symptoms within two weeks of antidepressant treatment is a highly sensitive but less specific predictor of later treatment outcome. The aim of this study was to identify clinical features at treatment initiation which are associated with early improvement and non-improvement as well as to identify variables predicting non-remission in patients showing an early improvement. Methods 889 patients with a major depressive episode according to DSM-IV who had participated in an antidepressant treatment trial served as study sample. Clinical predictors (demographic variables, psychopathology, comorbid disorders) were analysed in 698 (79%) early im…

Interventionen zur Resilienzförderung bei Erwachsenen

ZusammenfassungResilienz bezeichnet die Aufrechterhaltung bzw. rasche Wiederherstellung der psychischen Gesundheit während oder nach stressvollen Lebensumständen. Aktuelle Forschungsergebnisse legen nahe, dass Resilienz dynamisch ist und trainiert werden kann. Obwohl Interventionen zur Stärkung der Resilienz häufig zur Gesundheitsförderung bei verschiedenen Zielgruppen eingesetzt werden, ist deren Effektivität jedoch kaum systematisch untersucht. Diese Übersichtsarbeit beurteilt narrativ die Ergebnisse 4 systematischer Reviews und Metaanalysen zu Resilienzinterventionen bei Erwachsenen und fasst die Evidenz aus den randomisiert-kontrollierten Primärstudien (N=44) zusammen. Insgesamt erzielt…

Pharmacological interventions for schizotypal personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over a year due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn. To view the published versions of this article, please click the 'Other versions' tab.

Neurochemical alterations in women with borderline personality disorder and comorbid attention-deficit hyperactivity disorder

Borderline personality disorder (BPD) is associated with structural and functional brain changes. Recent models and findings refer to alterations of glutamate and total N-acetylaspartate (tNAA) in this condition.Absolute quantities of tNAA, creatine, glutamate, glutamine, myoinositol and total choline were measured using 3 Tesla magnetic resonance spectroscopy of the left anterior cingulate cortex and the left cerebellum in 14 unmedicated women with BPD and comorbid attention-deficit hyperactivity disorder (ADHD) and 18 healthy women. Both groups were matched with respect to age, education and premorbid intelligence.In the anterior cingulate, we found significantly higher tNAA and glutamate…

AS14-02 - Common and distinct treatment elements in psychotherapies for borderline personality disorder

Introduction Borderline personality disorder (BPD) is defined as “a pervasive pattern of instability of interpersonal relationships, self-image, affects, and marked impulsivity” (DSM-IV-TR; APA, 2000). These very characteristics make it difficult to establish firm therapeutic relationships and keep patients in treatment. In recent decades, a number of new psychotherapeutic approaches have been developed in order to meet these specific challenges and demands. To date, there is evidence of efficacy for various treatments, as data of a recent systematic review and meta-analysis of our working group indicate. Objectives To give an overview of all psychotherapeutic treatments investigated in ran…

Association analysis between gene variants of the tyrosine hydroxylase and the serotonin transporter in borderline personality disorder.

For patients with borderline personality disorder (BPD), we previously reported an independent effect of the catechol-o-methyl-transferase (COMT) low-activity (Met(158)) allele and an interaction with the low-expression allele of the deletion/insertion (short/long or S/L, resp.) polymorphism in the serotonin transporter-linked promoter region (5-HTTLPR). The purpose of the present study was to extend these findings to the tyrosine hydroxylase (TH) Val(81)Met single nucleotide polymorphism (SNP), the 5-HTTLPR S/L polymorphism incorporating the recently described functional A/G SNP within the long allele of the 5-HTTLPR (rs25531) as well as the variable number of tandem repeat (VNTR) polymorp…

Association analysis of SCN9A gene variants with borderline personality disorder

Borderline personality disorder (BPD) is a serious psychiatric disorder affecting about 1-2% of the general population. Key features of BPD are emotional instability, strong impulsivity, repeated self-injurious behavior (SIB) and dissociation. In the etiology of BPD and its predominant symptoms, genetic factors have been suggested. The voltage-gated sodium channel Nav1.7 is expressed in sensory neurons and in the hippocampus, a key region of the limbic system probably dysfunctional in BPD and dissociative disorders. The alpha-subunit of Nav1.7 is encoded by the SCN9A gene on chromosome 2 and variations of SCN9A can lead to complete inability to sense pain. The aim of the present study was t…

Pharmacotherapy of Borderline Personality Disorder: A Metaanalysis of Randomised Controlled Trials

Background:In Borderline Personality Disorder (BPD), pharmacotherapy is used for the treatment of specific BPD pathology facets, such as cognitive-perceptual, affective, or impulsivity symptoms. Due to the polymorphic phenomenology of the disorder, different classes of drugs are used, e.g., antipsychotics, antidepressants, or mood stabilizers.Aims:To evaluate the up-to-date evidence of drug treatment efficacy for BPD.Method:A systematic review and metaanalysis of randomised controlled trials was done. All randomised comparisons of drug vs. placebo, drug vs. drug, or drug vs. a combination of drugs in adult BPD patients were eligible for inclusion. Outcomes comprised BPD core pathology as de…

Longitudinal CSF proteome profiling in mice to uncover the acute and sustained mechanisms of action of rapid acting antidepressant (2R,6R)-hydroxynorketamine (HNK)

Delayed onset of antidepressant action is a shortcoming in depression treatment. Ketamine and its metabolite (2R,6R)-hydroxynorketamine (HNK) have emerged as promising rapid-acting antidepressants. However, their mechanism of action remains unknown. In this study, we first described the anxious and depression-prone inbred mouse strain, DBA/2J, as an animal model to assess the antidepressant-like effects of ketamine and HNK in vivo. To decode the molecular mechanisms mediating HNK's rapid antidepressant effects, a longitudinal cerebrospinal fluid (CSF) proteome profiling of its acute and sustained effects was conducted using an unbiased, hypothesis-free mass spectrometry-based proteomics app…

Psychological interventions to foster resilience in healthcare professionals.

Background Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. Objectives To assess the effects of interventions to foster resilience in healthcare professionals, t…

Neural correlates of interference inhibition, action withholding and action cancelation in adult ADHD

Attention-Deficit/Hyperactivity Disorder (ADHD) is marked by inhibitory and attentional deficits which can persist into adulthood. Those deficits have been associated with dysfunctional fronto-striatal and fronto-parietal circuits. The present study sought to delineate neural correlates of component specific inhibitory deficits in adult ADHD using functional magnetic resonance imaging (fMRI). 20 adult ADHD patients and 24 matched healthy controls were included. Brain activation was assessed during three stages of behavioral inhibition, i.e. interference inhibition (Simon task), action withholding (Go/no-go task) and action cancelation (Stop-signal task). Behaviorally, ADHD patients were aff…

Systematic review of psychotherapeutic treatments for “minor” personality disorders

IntroductionAmong personality disorders (PDs), antisocial and borderline personality disorder are well-studied. However, the remaining PDs (in the following called “minor PDs”) pose major problems in everyday-health care settings. People affected often present with additional axis-l disorders such as substance-related, mood or anxiety disorders, and are among those most difficult to treat.ObjectivesTo systematically review the current evidence of psychotherapeutic treatments for “minor” personality disordersMethodsIn the context of Cochrane Collaboration reviews for Cluster A, B and C PDs, exhaustive literature searches were done to identify the current RCT evidence for PD treatments. The e…

SPM-based count normalization provides excellent discrimination of mild Alzheimer's disease and amnestic mild cognitive impairment from healthy aging☆

Statistical comparisons of [(18)F]FDG PET scans between healthy subjects and patients with Alzheimer's disease (AD) or amnestic mild cognitive impairment (aMCI) using Statistical Parametric Mapping (SPM) usually require normalization of regional tracer uptake via ROIs defined using additional software. Here, we validate a simple SPM-based method for count normalization. FDG PET scans of 21 mild, 15 very mild AD, 11 aMCI patients and 15 age-matched controls were analyzed. First, we obtained relative increases in the whole patient sample compared to controls (i.e. areas relatively preserved in patients) with proportional scaling to the cerebral global mean (CGM). Next, average absolute counts…

Early reactions of brain-derived neurotrophic factor in plasma (pBDNF) and outcome to acute antidepressant treatment in patients with Major Depression.

Abstract In Major Depressive Disorder, a growing data base suggests that the onset of antidepressants’ action can be detected by improvement of depressive symptoms in the first 10–14 days of treatment. Previous studies showed that the mean concentration of the brain-derived neurotrophic factor (BDNF) in blood increases during antidepressant treatment and positively correlates with amelioration of MDD symptoms. We previously showed an association between very early changes of the serum BDNF concentration and treatment outcome ( Tadic et al., 2011 . Prog Neuropsychopharmacol Biol Psychiatry 35, 415–420). However, no study has yet investigated whether BDNF concentration in plasma increases in …

Do Mood Stabilizers Help in Borderline Personality Disorder?

BackgroundDespite the relatively weak evidence base, individuals with borderline personality disorder are often treated with pharmacological interventions. Amongst the drugs, which have shown most promise, are mood stabilizers, which were one of the two drug classes with the most beneficial effects in a previous cochrane review though the robustness of findings was described as low (Stoffers et al., 2010). Here we present data on the latest evidence for mood stabilizers based on an updated cochrane review currently underway.MethodsA systematic review and meta-analysis of randomized controlled trials was conducted. All randomized comparisons of drug vs. placebo, drug vs. drug, or drug vs. a …

Early improvement of executive test performance during antidepressant treatment predicts treatment outcome in patients with Major Depressive Disorder

Executive dysfunctions frequently occur in patients with Major Depressive Disorder and have been shown to improve during effective antidepressant treatment. However, the time course of improvement and its relationship to treatment outcome is unknown. The aim of the study was to assess the test performance and clinical outcome by repetitive assessments of executive test procedures during antidepressant treatment. Executive test performance was assessed in 209 –patients with Major Depressive Disorder (mean age 39.3 ± 11.4 years) and 84 healthy controls five times in biweekly intervals from baseline to week 8. Patients were treated by a defined treatment algorithm within the early medication c…

What users think about the differences between caffeine and illicit/prescription stimulants for cognitive enhancement

Pharmacological cognitive enhancement (CE) is a topic of increasing public awareness. In the scientific literature on student use of CE as a study aid for academic performance enhancement, there are high prevalence rates regarding the use of caffeinated substances (coffee, caffeinated drinks, caffeine tablets) but remarkably lower prevalence rates regarding the use of illicit/prescription stimulants such as amphetamines or methylphenidate. While the literature considers the reasons and mechanisms for these different prevalence rates from a theoretical standpoint, it lacks empirical data to account for healthy students who use both, caffeine and illicit/prescription stimulants, exclusively f…

Interaction between gene variants of the serotonin transporter promoter region (5-HTTLPR) and catecholO-methyltransferase (COMT) in borderline personality disorder

Borderline personality disorder (BPD) is characterized by a heterogeneous symptomatology with instability in impulse control, interpersonal relationships and self-image. BPD patients display repeated self-injury, chronic suicidal tendencies and emotional dysregulation, mainly dysregulation of negative affect. In its etiology, genetic and environmental factors have been suggested. Recently, an investigation in male healthy volunteers found gene–gene effects of the catechol-O-methyl-transferase (COMT) low-activity (Met158) and the low-expression allele of the deletion/insertion (short/long or S/L, respectively) polymorphism in the serotonin transporter-linked promoter region (5-HTTLPR) on the…

Differential nociceptive deficits in patients with borderline personality disorder and self-injurious behavior: laser-evoked potentials, spatial discrimination of noxious stimuli, and pain ratings.

Approximately 70-80% of women meeting criteria for borderline personality disorder (BPD) report attenuated pain perception or analgesia during non-suicidal, intentional self-mutilation. The aim of this study was to use laser-evoked potentials (LEPs) and psychophysical methods to differentiate the factors that may underlie this analgesic state. Ten unmedicated female patients with BPD (according to DSM-IV) and 14 healthy female control subjects were investigated using brief radiant heat pulses generated by a thulium laser and five-channel LEP recording. Heat pulses were applied as part of a spatial discrimination task (two levels of difficulty) and during a mental arithmetic task. BPD patien…

Decoding the Mechanism of Action of Rapid-Acting Antidepressant Treatment Strategies: Does Gender Matter?

Gender differences play a pivotal role in the pathophysiology and treatment of major depressive disorder. This is strongly supported by a mean 2:1 female-male ratio of depression consistently observed throughout studies in developed nations. Considering the urgent need to tailor individualized treatment strategies to fight depression more efficiently, a more precise understanding of gender-specific aspects in the pathophysiology and treatment of depressive disorders is fundamental. However, current treatment guidelines almost entirely neglect gender as a potentially relevant factor. Similarly, the vast majority of animal experiments analysing antidepressant treatment in rodent models exclus…

Protective and Risk Factors for Mental Distress and Its Impact on Health-Protective Behaviors during the SARS-CoV-2 Pandemic between March 2020 and March 2021 in Germany

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is posing a global public health burden. These consequences have been shown to increase the risk of mental distress, but the underlying protective and risk factors for mental distress and trends over different waves of the pandemic are largely unknown. Furthermore, it is largely unknown how mental distress is associated with individual protective behavior. Three quota samples, weighted to represent the population forming the German COVID-19 Snapshot Monitoring study (24 March and 26 May 2020, and 9 March 2021 with &gt

A Group Intervention to Promote Resilience in Nursing Professionals: A Randomised Controlled Trial

In this study, a new group intervention program to foster resilience in nursing professionals was tested for efficacy. In total, 72 nurses were recruited and randomised to either an intervention condition or to a wait list control condition. The study had a pre-test, post-test, follow-up design. The eight-week program targeted six resilience factors: cognitive flexibility, coping, self-efficacy, self-esteem, self-care, and mindfulness. Compared to the control group, the intervention group reported a significant improvement in the primary outcome mental health (measured with the General Health Questionnaire) from pre-test (M = 20.79; SD = 9.85) to post-test (M = 15.81; SD = 7.13) with an est…

Gender differences in axis I and axis II comorbidity in patients with borderline personality disorder.

&lt;i&gt;Background/Aims:&lt;/i&gt; Differences in the clinical presentation of men and women with borderline personality disorder (BPD) are of potential interest for investigations into the neurobiology, genetics, natural history, and treatment response of BPD. The purpose of this study was to investigate gender differences in axis I and axis II comorbidity and in diagnostic criteria in BPD patients. &lt;i&gt;Methods:&lt;/i&gt; 110 women and 49 men with BPD were assessed with the computer-based version of the Munich-Composite International Diagnostic Interview and the Structured Clinical Interview for DSM-IV Personality Disorders. Gender differences were investigated for the following outc…

Psychological interventions for people with narcissistic personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over a year due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn.

Population-based validation of a German version of the Brief Resilience Scale.

Smith and colleagues developed the Brief Resilience Scale (BRS) to assess the individual ability to recover from stress despite significant adversity. This study aimed to validate the German version of the BRS. We used data from a population-based (sample 1: n = 1.481) and a representative (sample 2: n = 1.128) sample of participants from the German general population (age ≥ 18) to assess reliability and validity. Confirmatory factor analyses (CFA) were conducted to compare one- and two-factorial models from previous studies with a method-factor model which especially accounts for the wording of the items. Reliability was analyzed. Convergent validity was measured by correlating BRS scores …

Prenatal adversity: a risk factor in borderline personality disorder?

BackgroundPatients with borderline personality disorder (BPD) show a high prevalence of early adversity, such as childhood trauma. It has also been reported that prenatal adverse conditions, such as prenatal maternal stress, drug taking, tobacco smoking or medical complications, may be associated with an increased risk of mental disorders in the offspring. Prenatal adversity is investigated here for the first time as a potential risk factor in the diagnosis of BPD.MethodA total of 100 patients with a DSM-IV diagnosis of BPD and 100 matched healthy controls underwent semi-structured interviews about the course of pregnancy, maternal stressors, birth complications and childhood trauma. Furthe…

Use of illicit and prescription drugs for cognitive or mood enhancement among surgeons

Disentangling common and specific neural subprocesses of response inhibition.

article i nfo Response inhibition is disturbed in several disorders sharing impulse control deficits as a core symptom. Since response inhibition is a cognitively and neurally multifaceted function which has been shown to rely on differing neural subprocesses and neurotransmitter systems, further differentiation to define neurophys- iological endophenotypes is essential. Response inhibition may involve at least three separable cognitive sub- components, i.e. interference inhibition, action withholding, and action cancelation. Here, we introduce a novel paradigm - the Hybrid Response Inhibition task - to disentangle interference inhibition, action withholding and action cancelation and their…

Dopamine D2/D3 receptor availability and venturesomeness.

The construct of impulsivity is considered as a major trait of personality. There is growing evidence that the mesolimbic dopamine system plays an important role in the modulation of impulsivity and venturesomeness, the two key components within the impulsivity-construct. The aim of the present study was to explore an association between trait impulsivity measured with self-assessment and the dopaminergic neurotransmission as measured by positron emission tomography (PET) in a cohort of healthy male subjects. In vivo D2/D3 receptor availability was determined with [(18)F]fallypride PET in 18 non-smoking healthy subjects. The character trait impulsivity was measured using the Impulsiveness-V…

Pharmacological interventions for people with histrionic personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over a year due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn. To view the published versions of this article, please click the 'Other versions' tab.

Impulsiveness and venturesomeness in German smokers.

Introduction Cigarette smoking is a behavior, which is influenced by genetic, demographic, and psychological factors. A large body of research has examined the association of cigarette smoking variables with individual differences in personality traits. The aim of the current study was to replicate the findings of higher self-reported impulsivity in smokers compared with never-smokers in a German sample using Eysenck´s construct of impulsivity. Furthermore, it was intended to further the knowledge about associations between different self-reported impulsivity components and different smoking variables. Methods We used the Impulsiveness-Venturesomeness-Empathy questionnaire (I7) to measure s…

Individual participant data systematic reviews with meta-analyses of psychotherapies for borderline personality disorder: A protocol

AbstractIntroductionThe heterogeneity in people with BPD and the range of specialised psychotherapies means that people with certain BPD characteristics might benefit more or less from different types of psychotherapy. Identifying moderating characteristics of individuals is a key to refine and tailor standard treatments so they match the specificities of the individual patient. The objective of this is to improve the quality of care and the individual outcomes. Thus, the aim of the current reviews is to investigate potential predictors and moderating patient characteristics on treatment outcomes for patients with BPD.Methods and analysisOur primary meta-analytic method will be the one-stag…

Extraction of prefronto-amygdalar pathways by combining probability maps

Many recent studies reported altered functional connectivity within the frontolimbic circuitry in a wide range of neuropsychiatric disorders. However, functional connectivity must rely on structural connections. In this study we applied a novel probabilistic fiber tracking method to assess the structural connectivity between the amygdala and different prefrontal brain regions in vivo. Twenty healthy subjects were investigated with diffusion tensor imaging. Probabilistic fiber tracking was started from the amygdala and different prefrontal brain regions. Resulting probability maps were combined using an extended multiplication of probabilistic maps to identify the most probable anatomical pa…

Challenges in the Transition from In-Patient to Out-Patient Treatment in Depression

Background Few data are available on the characteristics of inpatient treatment and subsequent outpatient treatment for depression in Germany. In this study, we aimed to characterize the inpatient and outpatient treatment phases, to determine the rates of readmission and mortality, and to identify risk factors. Methods We carried out a descriptive statistical analysis of routine administrative data from a large health-insurance carrier (BARMER). All insurees aged 18 to 65 who were treated in 2015 as inpatients on a psychiatry and psychotherapy service or on a psychosomatic medicine and psychotherapy service with a main diagnosis of depression were included in the analysis. Risk factors for …

Pharmakologisches Neuroenhancement: Substanzen und Epidemiologie

The catechol o-methyltransferase (COMT) val158met polymorphism modulates the association of serious life events (SLE) and impulsive aggression in female patients with borderline personality disorder (BPD)

Wagner S, Baskaya O, Anicker NJ, Dahmen N, Lieb K, Tadic A. The catechol o‐methyltransferase (COMT) val158met polymorphism modulates the association of serious life events (SLE) and impulsive aggression in female patients with borderline personality disorder (BPD). Objective: We analyzed i) the effects of serious life events (SLE) on impulsive aggression, and ii) modulating effects of the COMT Val158Met polymorphism on the association between SLEs and impulsive aggression in borderline personality disorder (BPD). Method: One hundred and twelve female BPD patients from Germany were included in this study. Impulsive aggression was assessed by the Buss‐Durkee‐Hostility Inventory (BDHI). Result…

Construct Validity and Population-Based Norms of the German Brief Resilience Scale (BRS).

Abstract. The Brief Resilience Scale (BRS) measures the ability to recover from stress. To provide further evidence for construct validity of the German BRS and to determine population-based norms, a large sample (N = 1,128) representative of the German adult population completed a survey including the BRS and instruments measuring perceived stress and the resilience factors optimism, self-efficacy, and locus of control. Confirmatory factor analyses showed best model fit for a five-factor model differentiating the ability to recover from stress from the three resilience factors. On the basis of latent and manifest correlations, convergent and discriminant validity of the BRS were fair to g…

Surprise: Unexpected Action Execution and Unexpected Inhibition Recruit the Same Fronto-Basal-Ganglia Network.

Unexpected and thus surprising events are omnipresent and oftentimes require adaptive behavior such as unexpected inhibition or unexpected action. The current theory of unexpected events suggests that such unexpected events just like global stopping recruit a fronto-basal-ganglia network. A global suppressive effect impacting ongoing motor responses and cognition is specifically attributed to the subthalamic nucleus (STN). Previous studies either used separate tasks or presented unexpected, task-unrelated stimuli during response inhibition tasks to relate the neural signature of unexpected events to that of stopping. Here, we aimed to test these predictions using a within task design with i…

Reduced interhemispheric structural connectivity between anterior cingulate cortices in borderline personality disorder

Functional and structural alterations of the anterior cingulate cortex (ACC), a key region for emotional and cognitive processing, are associated with borderline personality disorder (BPD). However, the interhemispheric structural connectivity between the left and right ACC and between other prefrontal regions in this condition is unknown. We acquired diffusion-tensor imaging data from 20 healthy women and 19 women with BPD and comorbid attention-deficit hyperactivity disorder (ADHD). Interhemispheric structural connectivity between both sides of the ACC, dorsolateral prefrontal cortices and medial orbitofrontal cortices was assessed by a novel probabilistic diffusion tensor-based fiber tra…

Randomized response estimates for the 12-month prevalence of cognitive-enhancing drug use in university students.

STUDY OBJECTIVE: To estimate the 12-month prevalence of cognitive-enhancing drug use. DESIGN: Paper-and-pencil questionnaire that used the randomized response technique. SETTING: University in Mainz, Germany. PARTICIPANTS: A total of 2569 university students who completed the questionnaire. MEASUREMENTS AND MAIN RESULTS: An anonymous, specialized questionnaire that used the randomized response technique was distributed to students at the beginning of classes and was collected afterward. From the responses, we calculated the prevalence of students taking drugs only to improve their cognitive performance and not to treat underlying mental disorders such as attention-deficit-hyperactivity diso…

Ambient Air Pollution Increases the Risk of Cerebrovascular and Neuropsychiatric Disorders through Induction of Inflammation and Oxidative Stress

Exposure to ambient air pollution is a well-established determinant of health and disease. The Lancet Commission on pollution and health concludes that air pollution is the leading environmental cause of global disease and premature death. Indeed, there is a growing body of evidence that links air pollution not only to adverse cardiorespiratory effects but also to increased risk of cerebrovascular and neuropsychiatric disorders. Despite being a relatively new area of investigation, overall, there is mounting recent evidence showing that exposure to multiple air pollutants, in particular to fine particles, may affect the central nervous system (CNS) and brain health, thereby contributing to …

Rapid acting antidepressant (2R,6R)-hydroxynorketamine (HNK) targets glucocorticoid receptor signaling: a longitudinal cerebrospinal fluid proteome study

AbstractDelayed onset of antidepressant action is a shortcoming in depression treatment. Ketamine and its metabolite (2R,6R)-hydroxynorketamine (HNK) have emerged as promising rapidacting antidepressants. However, their mechanism of action remains unknown. In this study, we first described the anxious and depression-prone inbred mouse strain, DBA/2J, as a animal model to assess the antidepressant-like effects of ketamine and HNK in vivo. To decode the molecular mechanisms mediating HNK’s rapid antidepressant effects, a longitudinal cerebrospinal fluid (CSF) proteome profiling of its acute and sustained effects was conducted using an unbiased, hypothesis-free mass spectrometry-based proteomi…

Molecular cause and functional impact of altered synaptic lipid signaling due to a prg‐1 gene SNP

Loss of plasticity-related gene 1 (PRG-1), which regulates synaptic phospholipid signaling, leads to hyperexcitability via increased glutamate release altering excitation/inhibition (E/I) balance in cortical networks. A recently reported SNP in prg-1 (R345T/ mutPRG-1) affects ~5 million European and US citizens in a monoallelic variant. Our studies show that this mutation leads to a loss-of-PRG-1 function at the synapse due to its inability to control lysophosphatidic acid (LPA) levels via a cellular uptake mechanism which appears to depend on proper glycosylation altered by this SNP. PRG-1 +/ mice, which are animal correlates of human PRG-1 +/mut carriers, showed an altered cortical networ…

Psychological interventions for people with histrionic personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over a year due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn. To view the published versions of this article, please click the 'Other versions' tab.

Mental health and psychosocial support strategies in highly contagious emerging disease outbreaks of substantial public concern: A systematic scoping review.

Background Acute disease outbreaks such as the COVID-19 pandemic cause a high burden of psychological distress in people worldwide. Interventions to enable people to better cope with such distress should be based on the best available evidence. We therefore performed a scoping review to systematically identify and summarize the available literature of interventions that target the distress of people in the face of highly contagious disease outbreaks. Methods MEDLINE, Cochrane CENTRAL, Web of Science (January 2000 to May 7, 2020), and reference lists were systematically searched and screened by two independent reviewers. Quantitative and qualitative studies investigating the effects of psyc…

Body mass index (BMI) in major depressive disorder and its effects on depressive symptomatology and antidepressant response

Obesity is one of the most prevalent somatic comorbidities of Major Depressive Disorder (MDD). We aimed to investigate the relationship between body mass index (BMI) and MDD, the symptomatology of the disorder as well as the outcome of antidepressant treatment.Early medication change (EMC) trial participants with BMI measurement (n = 811) were categorized according to WHO-criteria in normal or low weight (BMI  25), overweight (25- 30), and obese (≥30). Depression severity and BMI was assessed in weekly intervals up to 8 weeks. BMI at baseline and course of BMI during the study were investigated in linear regression models as possible moderators of therapy response. Possible moderators such …

Cannabis for Cognitive Enhancement as a New Coping Strategy? Results From a Survey of Students at Four Universities in Germany

Cognitive Enhancement (CE) is often discussed in relation to stimulant drugs, such as amphetamines (AMPH). However, there is some evidence that cannabis (CAN) can be used for CE.This study compares the knowledge, prevalence, and perceived effects of and factors associated with the knowledge of or use of CAN versus AMPH for CE among undergraduate students at four German universities.A survey was taken of 1,538 students at four German universities. It investigated their knowledge and use of CAN and AMPH for CE as well as associated factors. Descriptive and analytic (Mann-Whitney-U test, Fisher's exact test, logistic regression) statistics were obtained using SPSS.Responses were obtained from …

Escitalopram for the prevention of peginterferon-alpha2a-associated depression in hepatitis C virus-infected patients without previous psychiatric disease: a randomized trial

BACKGROUND: Depression is a major complication during treatment of chronic hepatitis C virus (HCV) infection with interferon-alpha (IFN-alpha). It is unclear whether antidepressants can prevent IFN-induced depression in patients without psychiatric risk factors. OBJECTIVE: To examine whether preemptive antidepressant treatment with escitalopram can decrease the incidence or severity of depression associated with pegylated IFN-alpha in HCV-infected patients without a history of psychiatric disorders. DESIGN: Randomized, multicenter, double-blind, prospective, placebo-controlled, parallel-group trial. (ClinicalTrials.gov registration number: NCT00136318) SETTING: 10 university and 11 academic…

Physical Activity in Polluted Air—Net Benefit or Harm to Cardiovascular Health? A Comprehensive Review

Both exposure to higher levels of polluted air and physical inactivity are crucial risk factors for the development and progression of major noncommunicable diseases and, in particular, of cardiovascular disease. In this context, the World Health Organization estimated 4.2 and 3.2 million global deaths per year in response to ambient air pollution and insufficient physical activity, respectively. While regular physical activity is well known to improve general health, it may also increase the uptake and deposit of air pollutants in the lungs/airways and circulation, due to increased breathing frequency and minute ventilation, thus increasing the risk of cardiovascular disease. Thus, determi…

Smoking and Neuropsychiatric Disease-Associations and Underlying Mechanisms.

Despite extensive efforts to combat cigarette smoking/tobacco use, it still remains a leading cause of global morbidity and mortality, killing more than eight million people each year. While tobacco smoking is a major risk factor for non-communicable diseases related to the four main groups—cardiovascular disease, cancer, chronic lung disease, and diabetes—its impact on neuropsychiatric risk is rather elusive. The aim of this review article is to emphasize the importance of smoking as a potential risk factor for neuropsychiatric disease and to identify central pathophysiological mechanisms that may contribute to this relationship. There is strong evidence from epidemiological and experiment…

Are Treatment Gains Maintained? Long-term Psychological Interventions for Bordeline Personality Disorder

IntroductionMany new approaches have been developed to treat borderline personality disorder (BPD) by means of psychotherapy. Though there is a clear research trend towards short-interventions, the evidence from randomised controlled trials (RCT) on longer-term programmes still accumulates. On the one hand, well-established treatments like Dialectical Behavior Therapy (DBT) or Mentalisation-Based Treatment (MBT) are now subject to real-world effectiveness studies; on the other hand, new dynamic approaches have been studied, lasting longer than 6 months.ObjectivesWe are currently updating the cochrane Collaboration review on psychological interventions for BPD. First findings on the effects …

The Amount of Mitochondrial DNA in Blood Reflects the Course of a Depressive Episode

Influence of gender on cytokine induced depression and treatment

Abstract Background Cytokine treatment with Interferon-alpha (IFN-α) represents a clinical model of immune associated depression, but it remains unclear if it is of the same entity as major depressive disorder (MDD). The study focuses on possible gender differences in IFN-α induced depression and effects of a pre-emptive antidepressant treatment. Methods Data from 181 patients with chronic hepatitis C infection (cHC) without history of mental illnesses undergoing treatment with IFN-α 2a and ribavirin were re-analyzed for gender effects. Patients with a pre-emptive antidepressant therapy with Escitalopram (n = 90, verum group) to prevent IFN-induced depression were compared to patients who r…

Pharmacological interventions for people with narcissistic personality disorder

Reason for withdrawal from publication Authors have made no progress with this protocol in over two years due to difficulties with identifying potentially suitable studies. The protocol has been withdrawn. To view the published versions of this article, please click the 'Other versions' tab.

Pharmacological Neuroenhancement: Substances and Epidemiology

Pharmacological neuroenhancement (PN) refers to the general use of psychoactive substances with the purpose of cognitive enhancement (e.g. enhancement of vigilance, concentration, memory or mood) by healthy subjects. Substances for PN include Over-the-Counter- (OTC-) substances such as coffee, caffeinated drinks/energy drinks, caffeine tablets and Ginkgo biloba as well as prescription drugs and illicit drugs (e.g. (psycho-) stimulants). “Brain doping” refers to the illicit use of a subcategory of these substances. On the one hand, this subcategory includes prescription drugs for the treatment of attention deficit/hyperactivity disorder (ADHD), sleep disorders, Alzheimer’s disease and depres…

Women with borderline personality disorder do not show altered BOLD responses during response inhibition.

Impulsivity is central to borderline personality disorder (BPD). Response inhibition, addressing the ability to suppress or stop actions, is one aspect of behavioral impulse control which is frequently used to assess impulsivity. BPD patients display deficits in response inhibition under stress condition or negative emotions. We assessed whether response inhibition and its neural underpinnings are impaired in BPD when tested in an emotionally neutral setting and when co-morbid attention-deficit/hyperactivity disorder (ADHD) is excluded. To this end, we studied response inhibition in unmedicated BPD patients and healthy controls (HC) in two independent samples using functional magnetic reson…

Assessment of Microstressors in Adults: Questionnaire Development and Ecological Validation of the Mainz Inventory of Microstressors

Background Many existing scales for microstressor assessment do not differentiate between objective (ie, observable) stressor events and stressful cognitions or concerns. They often mix items assessing objective stressor events with items measuring other aspects of stress, such as perceived stressor severity, the evoked stress reaction, or further consequences on health, which may result in spurious associations in studies that include other questionnaires that measure such constructs. Most scales were developed several decades ago; therefore, modern life stressors may not be represented. Ecological momentary assessment (EMA) allows for sampling of current behaviors and experiences in real…

Effectiveness of Antipsychotic Medication in the Treatment of BPD

IntroductionThough prescription is off-lable, “atypical” or “second-generation” antipsychotics (SGAs) are prevalently given to borderline personality disorder (BPD) patients. They have also been the focus of research on pharmacological agents in BPD in recent years, as the previous version of the relating cochrane systematic review shows.ObjectivesWe are currently updating this cochrane systematic review on pharmacological interventions for BPD. First findings on the up-to-date evidence relating to SGAs will be presented.MethodsWe conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) according to cochrane collaboration standards. Any randomized comparisons o…

Psychological interventions to foster resilience in healthcare students

Background Resilience can be defined as maintaining or regaining mental health during or after significant adversities such as a potentially traumatising event, challenging life circumstances, a critical life transition or physical illness. Healthcare students, such as medical, nursing, psychology and social work students, are exposed to various study- and work-related stressors, the latter particularly during later phases of health professional education. They are at increased risk of developing symptoms of burnout or mental disorders. This population may benefit from resilience-promoting training programmes. Objectives To assess the effects of interventions to foster resilience in healthc…

Intervention studies to foster resilience – A systematic review and proposal for a resilience framework in future intervention studies

Psychological resilience refers to the phenomenon that many people are able to adapt to the challenges of life and maintain mental health despite exposure to adversity. This has stimulated research on training programs to foster psychological resilience. We evaluated concepts, methods and designs of 43 randomized controlled trials published between 1979 and 2014 which assessed the efficacy of such training programs and propose standards for future intervention research based on recent developments in the field. We found that concepts, methods and designs in current resilience intervention studies are of limited use to properly assess efficacy of interventions to foster resilience. Major pro…