@article{PfennigLeopoldBechdolfetal.2014, author = {Pfennig, Andrea and Leopold, Karolina and Bechdolf, Andreas and Correll, Christoph U. and Holtmann, Martin and Lambert, Martin and Marx, Carolin and Meyer, Thomas D. and Pfeiffer, Steffi and Reif, Andreas and Rottmann-Wolf, Maren and Schmitt, Natalie M. and Stamm, Thomas and Juckel, Georg and Bauer, Michael}, title = {Early specific cognitive-behavioural psychotherapy in subjects at high risk for bipolar disorders: study protocol for a randomised controlled trial}, series = {TRIALS}, volume = {15}, journal = {TRIALS}, number = {161}, issn = {1468-6694}, doi = {10.1186/1745-6215-15-161}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-116279}, year = {2014}, abstract = {Background: Bipolar disorders (BD) are among the most severe mental disorders with first clinical signs and symptoms frequently appearing in adolescence and early adulthood. The long latency in clinical diagnosis (and subsequent adequate treatment) adversely affects the course of disease, effectiveness of interventions and health-related quality of life, and increases the economic burden of BD. Despite uncertainties about risk constellations and symptomatology in the early stages of potentially developing BD, many adolescents and young adults seek help, and most of them suffer substantially from symptoms already leading to impairments in psychosocial functioning in school, training, at work and in their social relationships. We aimed to identify subjects at risk of developing BD and investigate the efficacy and safety of early specific cognitive-behavioural psychotherapy (CBT) in this subpopulation. Methods/Design: EarlyCBT is a randomised controlled multi-centre clinical trial to evaluate the efficacy and safety of early specific CBT, including stress management and problem solving strategies, with elements of mindfulness-based therapy (MBT) versus unstructured group meetings for 14 weeks each and follow-up until week 78. Participants are recruited at seven university hospitals throughout Germany, which provide in-and outpatient care (including early recognition centres) for psychiatric patients. Subjects at high risk must be 15 to 30 years old and meet the combination of specified affective symptomatology, reduction of psychosocial functioning, and family history for (schizo) affective disorders. Primary efficacy endpoints are differences in psychosocial functioning and defined affective symptomatology at 14 weeks between groups. Secondary endpoints include the above mentioned endpoints at 7, 24, 52 and 78 weeks and the change within groups compared to baseline; perception of, reaction to and coping with stress; and conversion to full BD. Discussion: To our knowledge, this is the first study to evaluate early specific CBT in subjects at high risk for BD. Structured diagnostic interviews are used to map the risk status and development of disease. With our study, the level of evidence for the treatment of those young patients will be significantly raised.}, language = {en} } @article{KaramustafalıoğluReifAtmacaetal.2014, author = {Karamustafal{\i}oğlu, Oğuz and Reif, Andreas and Atmaca, Murad and Gonzalez, Domingo and Moreno-Manzanaro, Miriam and Gonzalez, Miguel Angel and Medina, Esteban and Bellomo, Antonello}, title = {Hospital stay in patients admitted for acute bipolar manic episodes prescribed quetiapine immediate or extended release: a retrospective non-interventional cohort study (HOME)}, series = {BMC Psychiatry}, volume = {14}, journal = {BMC Psychiatry}, number = {246}, doi = {10.1186/s12888-014-0246-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-115547}, year = {2014}, abstract = {Background: Bipolar manic episodes often require hospital admission to ensure patient safety. The antipsychotic quetiapine is a common treatment for bipolar mania and is available in immediate release (IR) and extended release (XR) formulations; however, outcomes in patients receiving these different formulations have not been directly compared in an acute hospital setting. Methods: We conducted a multinational, observational, retrospective cohort study to describe and compare hospital stay in patients admitted for an acute bipolar manic episode treated with quetiapine IR or XR from 1 October 2009-1 October 2010. The primary outcome measure was comparison of length of stay (LOS) using zero-truncated negative binomial regression. Results: In total, 1230 patients were included (659 in the IR cohort; 571 in the XR cohort). The median LOS (interquartile range) was 18.0 days (12.0, 28.0) in the IR cohort and 20.0 days (12.0, 34.0) in the XR cohort, respectively. LOS was not significantly associated with quetiapine formulation irrespective of whether or not clinical characteristics were taken into account (p = 0.820 and p = 0.386, respectively). Overall, 84.2\% and 84.4\% of patients in the IR and XR cohorts, respectively, had not previously used quetiapine; of these patients, 78.7\% and 68.9\% received one total daily dose, and 14.4\% and 23.9\% received dose titration. Over half of patients received antipsychotic monotherapy (53.1\% and 58.3\% in the IR and XR cohorts, respectively) and most received a daily quetiapine dose >= 400 mg (64.9\% and 71.8\%, respectively, for quetiapine monotherapy and 59.9\% and 80.3\%, respectively, for combination treatment). As a secondary outcome, multivariate analysis was used to identify other factors that affect LOS. Factors associated with a longer hospital stay included public funding versus private, maximum number of new medications administered, did not receive lithium and did not receive anxiolytics, sedatives/hypnotics (all p < 0.0001). Factors associated with a shorter hospital stay included presence of drug/alcohol abuse, living accompanied and having a psychiatric medical history (all p < 0.05). Conclusions: LOS was not found to be associated with quetiapine formulation. However, most patients received only one total daily dose of quetiapine without dose titration, which was unexpected and contrary to current recommendations.}, language = {en} } @article{HahnKarolienDresleretal.2014, author = {Hahn, Tim and Karolien, Hilde and Dresler, Thomas and Kowarsch, Linda and Reif, Andreas and Fallgatter, Andreas J.}, title = {Linking online gaming and addictive behavior: converging evidence for a general reward deficiency in frequent online garners}, series = {Frontiers in Behavioral Neuroscience}, volume = {14}, journal = {Frontiers in Behavioral Neuroscience}, number = {8}, issn = {1662-5153}, doi = {10.3389/fnbeh.2014.00385}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-114737}, year = {2014}, abstract = {Millions of people regularly play so-called massively multiplayer online role playing games (MMORPGs). Recently, it has been argued that MMORPG overuse is becoming a significant health problem worldwide. Symptoms such as tolerance, withdrawal, and craving have been described. Based on behavioral, resting state, and task-related neuroimaging data, we test whether frequent players of the MMORPG "World of VVarcraft" (WoW) similar to drug addicts and individuals with an increased risk for addictions show a generally deficient reward system. In frequent players of the MMORPG "World of VVarcraft" (WoW-players) and in a control group of non-gamers we assessed (1) trait sensitivity to reward (SR), (2) BOLD responses during monetary reward processing in the ventral striatum, and (3) ventral-striatal resting-state dynamics. We found a decreased neural activation in the ventral striatum during the anticipation of both small and large monetary rewards. Additionally, we show generally altered neurodynamics in this region independent of any specific task for WoW players (resting state). On the behavioral level, we found differences in trait SR, suggesting that the reward processing deficiencies found in this study are not a consequence of gaming, but predisposed to it. These findings empirically support a direct link between frequent online gaming and the broad field of behavioral and drug addiction research, thus opening new avenues for clinical interventions in addicted gamers and potentially improving the assessment of addiction-risk in the vast population of frequent gamers.}, language = {en} } @article{VolkertZierhutSchieleetal.2014, author = {Volkert, Julia and Zierhut, Kathrin C. and Schiele, Miriam A. and Wenzel, Martina and Kopf, Juliane and Kittel-Schneider, Sarah and Reif, Andreas}, title = {Predominant polarity in bipolar disorder and validation of the polarity index in a German sample}, doi = {10.1186/s12888-014-0322-8}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-111042}, year = {2014}, abstract = {Background: A large number of patients with bipolar disorder (BD) can be characterized by predominant polarity (PP), which has important implications for relapse prevention. Recently, Popovic et al. (EUR NEUROPSYCHOPHARM 22(5): 339-346, 2012) proposed the Polarity Index (PI) as a helpful tool in the maintenance treatment of BD. As a numeric expression, it reflects the efficacy of drugs used in treatment of BD. In the present retrospective study, we aimed to validate this Index in a large and well characterized German bipolar sample. Methods: We investigated 336 bipolar patients (BP) according to their PP and calculated the PI for each patient in order to prove if maintenance treatment differs according to their PP. Furthermore, we analysed whether PP is associated with demographic and clinical characteristics of BP. Results: In our sample, 63.9\% of patients fulfilled criteria of PP: 169 patients were classified as depressive predominant polarity (DPP), 46 patients as manic predominant polarity (MPP). The two groups differed significantly in their drug regime: Patients with DPP were more often medicated with lamotrigine and antidepressants, patients with MPP were more often treated with lithium, valproate, carbamazepine and first generation antipsychotics. However, patients with DPP and MPP did not differ significantly with respect to the PI, although they received evidence-based and guideline-driven treatment. Conclusion: The reason for this negative finding might well be that for several drugs, which were used frequently, no PI value is available. Nevertheless we suggest PP as an important concept in the planning of BD maintenance treatment.}, language = {en} }