Interventionen bei frühkindlichen Regulationsstörungen besitzen eine gesamtgesellschaftliche Bedeutung für die Prävention von Entwicklungsstörungen. Bisher existieren wenige Studien zur Wirksamkeit niedrigschwelliger Beratungsangebote. Diese Arbeit beinhaltet einen umfassenden theoretischen Überblick sowie ein systematic review zu Interventionen in diesem Fachbereich. Die Wirksamkeitsstudie wurde als nicht-randomisiertes prospektives Parallelgruppen-prä-post-Design durchgeführt. Die Interventionsgruppe erhielt eine Beratung im Rahmen der Sprechstunde für Kleinkinder in einem Sozialpädiatrischen Zentrum. Die Studienergebnisse zeigen, dass die Inanspruchnahme der Beratung zu einer signifikant stärkeren Reduktion der Regulations- und sozial-emotionalen Probleme, insbesondere der Schlafprobleme und der internalen Probleme der Kinder führt. Darüber hinaus kommt es zu einer Reduktion der wahrgenommenen Belastung der Eltern sowie zu einer Erhöhung der Lebensqualität der Familien. Die vorliegende Arbeit liefert wichtige Hinweise auf eine Effektivität der Beratung bei Kleinkindern mit Regulationsproblemen.
Interventions for early childhood regulatory disorders have a societal significance for the prevention of developmental disorders. There are only few studies on their effectiveness of low-threshold counseling services. This work includes a comprehensive theoretical overview as well as a systematic review of interventions in this field. The efficacy study was conducted as a non-randomized prospective study with a parallel group pre-post design. The intervention group received advice as part of the regulatory consultation. The study results show that the use of counseling leads to a significantly greater reduction in regulatory and social-emotional problems, especially sleep problems and internal problems of the children. In addition, there is a reduction in the perceived stress of the parents and an increase in the quality of life of the families. This study provides important evidence of the effectiveness of counseling for young children with regulation problems.
Lithium is regarded as the first-line treatment for bipolar disorder (BD), a severe and disabling mental health disorder that affects about 1% of the population worldwide. Nevertheless, lithium is not consistently effective, with only 30% of patients showing a favorable response to treatment. To provide personalized treatment options for bipolar patients, it is essential to identify prediction biomarkers such as polygenic scores. In this study, we developed a polygenic score for lithium treatment response (Li+PGS) in patients with BD. To gain further insights into lithium’s possible molecular mechanism of action, we performed a genome-wide gene-based analysis. Using polygenic score modeling, via methods incorporating Bayesian regression and continuous shrinkage priors, Li+PGS was developed in the International Consortium of Lithium Genetics cohort (ConLi+Gen: N = 2367) and replicated in the combined PsyCourse (N = 89) and BipoLife (N = 102) studies. The associations of Li+PGS and lithium treatment response — defined in a continuous ALDA scale and a categorical outcome (good response vs. poor response) were tested using regression models, each adjusted for the covariates: age, sex, and the first four genetic principal components. Statistical significance was determined at P < 0.05. Li+PGS was positively associated with lithium treatment response in the ConLi+Gen cohort, in both the categorical (P = 9.8 × 10−12, R2 = 1.9%) and continuous (P = 6.4 × 10−9, R2 = 2.6%) outcomes. Compared to bipolar patients in the 1st decile of the risk distribution, individuals in the 10th decile had 3.47-fold (95%CI: 2.22-5.47) higher odds of responding favorably to lithium. The results were replicated in the independent cohorts for the categorical treatment outcome (P = 3.9 × 10−4, R2 = 0.9%), but not for the continuous outcome (P = 0.13). Gene-based analyses revealed 36 candidate genes that are enriched in biological pathways controlled by glutamate and acetylcholine. Li+PGS may be useful in the development of pharmacogenomic testing strategies by enabling a classification of bipolar patients according to their response to treatment.
von Jesko Marian Momotow ; Ina Bühnen ; Karolin Trautmann-Grill ; Guido Kobbe ; Dennis Hahn ; Roland Schroers ; Bernhard Heinrich ; Tobias Gaska ; Helmut Forstbauer ; Burkhard Schmidt ; Regina Boger ; Andreas Hüttmann ; Gerhard Heil ; Doris M. Kraemer ; William H. Krüger ; Vanja Zeremski ; Norbert Grobe ; Kathleen Jentsch-Ullrich ; Frank Griesinger ; Michael Fuchs ; Bastian von Tresckow ; Peter Borchmann ; Andreas Engert ; Paul Jan Bröckelmann
von Jutta Keller ; Thilo Wedel ; Holger Seidl ; Martin Ernst Kreis ; Ivo Raymond van der Voort ; Maximilian Gebhard ; Jost Langhorst ; Petra Lynen ; Oliver Schwandner ; Martin Storr ; Pia van Leeuwen ; Viola Andresen ; Jan Preiß ; Peter Layer ; Hans-Dieter Allescher ; Tilo Andus ; Stephan C. Bischoff ; Stephan Buderus ; M. Claßen ; U. Ehlert ; S. Elsenbruch ; M. Engel ; Axel Enninger ; Wolfgang Fischbach ; Michael H. Freitag ; Thomas Frieling ; Anton Gillessen ; M. Goebel-Stengel ; Juliane Dorothee Gschoßmann ; Felix Gundling ; S. Haag ; W. Häuser ; Ulf Helwig ; Stephan Hollerbach ; G. Holtmann ; M. Karaus ; M. Katschinski ; H. Krammer ; Wolfgang Kruis ; R. Kuhlbusch-Zicklam ; Ahmed Madisch ; H. Matthes ; Stephan Miehlke ; Hubert Mönnikes ; Stefan Müller-Lissner ; B. Niesler ; C. Pehl ; D. Pohl ; Carsten Posovszky ; M. Raithel ; Gabriele Röhrig-Herzog ; R. Schäfert ; M. Schemann ; Anjona Schmidt-Choudhury ; S. Schmiedel ; Anna Schweinlin ; Ilja Juliane Dorothee Schwille-Kiuntke ; A. Stengel ; Jonas Tesarz ; W. Voderholzer ; G. von Boyen ; J. von Schönfeld
