Objective: The hospitalization of patients for medical reasons potentially generates enormous psychological stress and may evoke psychiatric pathology of the affective/anxiety-spectrum. It is well known that affective disorders are very common diagnoses among somatically ill patients. Here, we further investigated the characteristics of depression and anxiety in hospital patients by studying data from a large sample of psychiatric consultations of medical inpatients. Methods: In a prospective, observational design we collected and analyzed data from 890 psychiatric consultations of somatically ill hospital patients, who required psychiatric assessment by consultation-liaison services due to acute psychopathology. Only data that were collected as part of the routine psychiatric care were processed for this study. Patients were seen in two German hospitals, Klinikum Forchheim and University Clinic Erlangen. More than 90% of consultations were carried out by the same three psychiatrists. Results: Affective disorders were the most common diagnoses given to patients as a result of the consultation (39.2%). A further 10.4% of patients suffered from reaction to severe stress and adjustment disorders and 7.7% suffered from anxiety disorders. More than 80% of patients with disorders of the affective/anxiety spectrum required further treatment following the consultation, and 36.1% of patients with affective disorders required inpatient psychiatric treatment. Relatively few patients had received regular psychiatric treatment or psychotherapy prior to the hospital stay (24.8% for affective disorders, 19.1% for anxiety disorders and 9.2% for reaction to severe stress and adjustment disorders), yet 82.5% of patients had a pre-existing psychiatric diagnosis. Conclusion: Our findings underline the potential of a medical hospital stay to trigger substantial psychiatric symptoms in patients with and without a pre-known psychiatric diagnosis. Patients with a pre-existing diagnosis of affective or anxiety disorders seem to be at particular risk of developing psychopathology in the course of a somatic hospital stay. Better routine psychiatric care is needed to prevent the development or exacerbation of psychopathology in hospital patients.
Journal of depression & anxiety Los Angeles, CA : OMICS Publ. Group, 2012 Bd. 6.2017, 3, Art.-Nr. 1000276, insges. 5 S. Online-Ressource
von Peter Sörös ; Katharina Bachmann ; Alexandra Philomena Lam ; Manuela Kanat ; Eliza Hoxhaj ; Swantje Dorothea Matthies ; Bernd Feige ; Helge H. O. Müller ; Christiane M. Thiel ; Alexandra Philipsen
Attention-deficit/hyperactivity disorder (ADHD) is a recognized serious mental disorder that often persists into adulthood. The symptoms and impairments associated with ADHD often cause significant mental suffering in affected individuals. ADHD has been associated with abnormal neuronal activity in various neuronal circuits, such as the dorsofrontostriatal, orbitofrontostriatal, and frontocerebellar circuits. Psychopharmacological treatment with methylphenidate hydrochloride is recommended as the first-line treatment for ADHD. It is assumed that medication ameliorates ADHD symptoms by improving the functioning of the brain areas affected in the condition. However, side effects, contraindications, or non-response can limit the effectiveness of a psychopharmacological treatment for ADHD. It is therefore necessary to develop non-pharmacological interventions that target neuronal mechanisms associated with the condition in the same way as pharmacological treatment. We think that mindfulness meditation employed as a neuropsychotherapeutic intervention could help patients with ADHD to regulate impaired brain functioning and thereby reduce ADHD symptoms. In this paper, we highlight the mechanisms of such mindfulness meditation, and thus provide a rationale for further research and treatment development from a neuropsychotherapeutic perspective. We conclude that mindfulness meditation employed as a neuropsychotherapeutic intervention in therapy is a promising treatment approach in ADHD.
Frontiers in psychiatry Lausanne : Frontiers Research Foundation, 2007 Bd. 7 (2016), 27. (Jun.), Article 117, insges. 7 S. Online-Ressource
