@article{AngermannAssmusAnkeretal.2020, author = {Angermann, Christiane E. and Assmus, Birgit and Anker, Stefan D. and Asselbergs, Folkert W. and Brachmann, Johannes and Brett, Marie-Elena and Brugts, Jasper J. and Ertl, Georg and Ginn, Greg and Hilker, Lutz and Koehler, Friedrich and Rosenkranz, Stephan and Zhou, Qian and Adamson, Philip B. and B{\"o}hm, Michael}, title = {Pulmonary artery pressure-guided therapy in ambulatory patients with symptomatic heart failure: the CardioMEMS European Monitoring Study for Heart Failure (MEMS-HF)}, series = {European Journal of Heart Failure}, volume = {22}, journal = {European Journal of Heart Failure}, number = {10}, doi = {10.1002/ejhf.1943}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218061}, pages = {1891 -- 1901}, year = {2020}, abstract = {Aims Heart failure (HF) leads to repeat hospitalisations and reduces the duration and quality of life. Pulmonary artery pressure (PAP)-guided HF management using the CardioMEMS™ HF system was shown to be safe and reduce HF hospitalisation (HFH) rates in New York Heart Association (NYHA) class III patients. However, these findings have not been replicated in health systems outside the United States. Therefore, the CardioMEMS European Monitoring Study for Heart Failure (MEMS-HF) evaluated the safety, feasibility, and performance of this device in Germany, The Netherlands, and Ireland. Methods and results A total of 234 NYHA class III patients (68 ± 11 years, 22\% female, ≥1 HFH in the preceding year) from 31 centres were implanted with a CardioMEMS sensor and underwent PAP-guided HF management. One-year rates of freedom from device- or system-related complications and from sensor failure (co-primary outcomes) were 98.3\% [95\% confidence interval (CI) 95.8-100.0] and 99.6\% (95\% CI 97.6-100.0), respectively. Survival rate was 86.2\%. For the 12 months post- vs. pre-implant, HFHs decreased by 62\% (0.60 vs. 1.55 events/patient-year; hazard ratio 0.38, 95\% CI 0.31-0.48; P < 0.0001). After 12 months, mean PAP decreased by 5.1 ± 7.4 mmHg, Kansas City Cardiomyopathy Questionnaire (KCCQ) overall/clinical summary scores increased from 47.0 ± 24.0/51.2 ± 24.8 to 60.5 ± 24.3/62.4 ± 24.1 (P < 0.0001), and the 9-item Patient Health Questionnaire sum score improved from 8.7 ± 5.9 to 6.3 ± 5.1 (P < 0.0001). Conclusion Haemodynamic-guided HF management proved feasible and safe in the health systems of Germany, The Netherlands, and Ireland. Physician-directed treatment modifications based on remotely obtained PAP values were associated with fewer HFH, sustainable PAP decreases, marked KCCQ improvements, and remission of depressive symptoms.}, language = {en} } @article{ArnoldMuellerOerlinghausenHemrichetal.2020, author = {Arnold, Michaela Maria and M{\"u}ller-Oerlinghausen, Bruno and Hemrich, Norbert and B{\"o}nsch, Dominikus}, title = {Effects of Psychoactive Massage in Outpatients with Depressive Disorders: A Randomized Controlled Mixed-Methods Study}, series = {Brain Sciences}, volume = {10}, journal = {Brain Sciences}, number = {10}, issn = {2076-3425}, doi = {10.3390/brainsci10100676}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-213385}, year = {2020}, abstract = {The clinical picture of depressive disorders is characterized by a plethora of somatic symptoms, psychomotor retardation, and, particularly, anhedonia. The number of patients with residual symptoms or treatment resistance is high. Touch is the basic communication among humans and animals. Its application professionally in the form of, e.g., psychoactive massage therapy, has been shown in the past to reduce the somatic and mental symptoms of depression and anxiety. Here, we investigated the effects of a specially developed affect-regulating massage therapy (ARMT) vs. individual treatment with a standardized relaxation procedure, progressive muscle relaxation (PMR), in 57 outpatients with depression. Patients were given one ARMT or PMR session weekly over 4 weeks. Changes in somatic and cognitive symptoms were assessed by standard psychiatric instruments (Hamilton Depression Scale (HAMD) and the Bech-Rafaelsen-Melancholia-Scale (BRMS)) as well as a visual analogue scale. Furthermore, oral statements from all participants were obtained in semi-structured interviews. The findings show clear and statistically significant superiority of ARMT over PMR. The results might be interpreted within various models. The concept of interoception, as well as the principles of body psychotherapy and phenomenological aspects, offers cues for understanding the mechanisms involved. Within a neurobiological context, the significance of C-tactile afferents activated by special touch techniques and humoral changes such as increased oxytocin levels open additional ways of interpreting our findings.}, language = {en} } @article{BiereKranzMaturaetal.2020, author = {Biere, Silvia and Kranz, Thorsten M. and Matura, Silke and Petrova, Kristiyana and Streit, Fabian and Chiocchetti, Andreas G. and Grimm, Oliver and Brum, Murielle and Brunkhorst-Kanaan, Natalie and Oertel, Viola and Malyshau, Aliaksandr and Pfennig, Andrea and Bauer, Michael and Schulze, Thomas G. and Kittel-Schneider, Sarah and Reif, Andreas}, title = {Risk Stratification for Bipolar Disorder Using Polygenic Risk Scores Among Young High-Risk Adults}, series = {Frontiers in Psychiatry}, volume = {11}, journal = {Frontiers in Psychiatry}, doi = {10.3389/fpsyt.2020.552532}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-214976}, year = {2020}, abstract = {Objective: Identifying high-risk groups with an increased genetic liability for bipolar disorder (BD) will provide insights into the etiology of BD and contribute to early detection of BD. We used the BD polygenic risk score (PRS) derived from BD genome-wide association studies (GWAS) to explore how such genetic risk manifests in young, high-risk adults. We postulated that BD-PRS would be associated with risk factors for BD. Methods: A final sample of 185 young, high-risk German adults (aged 18-35 years) were grouped into three risk groups and compared to a healthy control group (n = 1,100). The risk groups comprised 117 cases with attention deficit hyperactivity disorder (ADHD), 45 with major depressive disorder (MDD), and 23 help-seeking adults with early recognition symptoms [ER: positive family history for BD, (sub)threshold affective symptomatology and/or mood swings, sleeping disorder]. BD-PRS was computed for each participant. Logistic regression models (controlling for sex, age, and the first five ancestry principal components) were used to assess associations of BD-PRS and the high-risk phenotypes. Results: We observed an association between BD-PRS and combined risk group status (OR = 1.48, p < 0.001), ADHD diagnosis (OR = 1.32, p = 0.009), MDD diagnosis (OR = 1.96, p < 0.001), and ER group status (OR = 1.7, p = 0.025; not significant after correction for multiple testing) compared to healthy controls. Conclusions: In the present study, increased genetic risk for BD was a significant predictor for MDD and ADHD status, but not for ER. These findings support an underlying shared risk for both MDD and BD as well as ADHD and BD. Improving our understanding of the underlying genetic architecture of these phenotypes may aid in early identification and risk stratification.}, language = {en} } @phdthesis{Brueser2020, author = {Br{\"u}ser, Judith}, title = {Pr{\"u}fung der Effektivit{\"a}t eines interdisziplin{\"a}ren psychokardiologischen Behandlungsprogrammes auf die Reduktion von Depressivit{\"a}t, Angst und Panik und die Verbesserung der gesundheitsbezogenen Lebensqualit{\"a}t bei psychisch belasteten kardiologischen Rehabilitanden}, doi = {10.25972/OPUS-19823}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-198233}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {In dieser Arbeit wurde gepr{\"u}ft, ob ein leitlinienkonformes psychokardiologisches Behandlungskonzept einer herk{\"o}mmlichen kardiologischen Behandlung bei psychisch belasteten kardiologischen Rehabilitanden in der Reduktion von Angst, Depression und Panik (prim{\"a}re Zielkriterien) und einer Verbesserung der gesundheitsbezogenen Lebensqualit{\"a}t (sekund{\"a}re Zielparameter) {\"u}berlegen ist. In der Nebenfragstellung wurden Unterschiede in der Wirksamkeit der Intervention in Abh{\"a}ngigkeit vom Geschlecht explorativ gepr{\"u}ft. Die Fragestellungen wurden mit einem quasiexperimentellen Studiendesign mit sequentiell aufeinanderfolgenden Kohorten untersucht. Die Zielparameter wurden zu Rehabeginn, -ende und 6 Monate nach Entlassung mit validierten Frageb{\"o}gen (PHQ-9, PHQ-Panik, GAD-7 und MacNew Heart Disease-Fragebogen) erfasst. Die Hauptanalyse ergab einen kleinen signifikanten Intergruppeneffekt f{\"u}r den Zielparameter Depressivit{\"a}t zugunsten der Kontrollgruppe zu Rehaende und in der Katamnese keine signifikanten Unterschiede im Behandlungserfolg beider Studienbedingungen mehr. Die Moderatoranalyse ergab kleine Interaktionseffekte zwischen Intervention und Geschlecht f{\"u}r Angst und die gesundheitsbezogene Lebensqualit{\"a}t zu beiden Folgemess-zeitpunkten. Deskriptiv zeigte sich der Trend, dass Frauen von der Interventionsbedingung schlechter, M{\"a}nner hingegen besser profitierten. F{\"u}r die mangelnde {\"U}berlegenheit des Interventionsprogrammes kommen vielf{\"a}ltige Aspekte in Frage, die methodisch das sequentiell aufeinanderfolgenden Behandlungsdesign betreffen sowie interventionsbezogen die Aussch{\"o}pfung der Therapieressourcen, den Zeitpunkt des Behandlungsbeginns, die Behandlungsdauer, die Ber{\"u}cksichtigung spezifischer Patientenbed{\"u}rfnisse und auch die M{\"o}glichkeit einer ung{\"u}nstigen Wirkung von Psychotherapie. Ferner war die statistische Power und damit die Aussagekraft der Studie einschr{\"a}nkt. Als Fazit unterliegen noch vielf{\"a}ltige Einflussgr{\"o}ßen gezieltem Forschungsbedarf.}, subject = {Depression}, language = {de} } @article{EsserMehnert‐TheuerkaufFriedrichetal.2020, author = {Esser, Peter and Mehnert-Theuerkauf, Anja and Friedrich, Michael and Johansen, Christoffer and Br{\"a}hler, Elmar and Faller, Hermann and H{\"a}rter, Martin and Koch, Uwe and Schulz, Holger and Wegscheider, Karl and Weis, Joachim and Kuba, Katharina and Hinz, Andreas and Hartung, Tim}, title = {Risk and associated factors of depression and anxiety in men with prostate cancer: Results from a German multicenter study}, series = {Psycho-Oncology}, volume = {29}, journal = {Psycho-Oncology}, number = {10}, doi = {10.1002/pon.5471}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-218277}, pages = {1604 -- 1612}, year = {2020}, abstract = {Objective In order to optimize psycho-oncological care, studies that quantify the extent of distress and identify certain risk groups are needed. Among patients with prostate cancer (PCa), findings on depression and anxiety are limited. Methods We analyzed data of PCa patients selected from a German multi-center study. Depression and anxiety were assessed with the PHQ-9 and the GAD-7 (cut-off ≥7). We provided physical symptom burden, calculated absolute and relative risk (AR and RR) of depression and anxiety across patient subsets and between patients and the general population (GP) and tested age as a moderator within the relationship of disease-specific symptoms with depression and anxiety. Results Among 636 participants, the majority reported disease-specific problems (sexuality: 60\%; urination: 52\%). AR for depression and anxiety was 23\% and 22\%, respectively. Significant RR were small, with higher risks of distress in patients who are younger (eg, RR\(_{depression}\) = 1.15; 95\%-CI: 1.06-1.26), treated with chemotherapy (RR\(_{depression}\)n = 1.46; 95\%-CI: 1.09-1.96) or having metastases (RR\(_{depression}\) = 1.30; 95\%-CI: 1.02-1.65). Risk of distress was slightly elevated compared to GP (eg, RR\(_{depression}\) = 1.13; 95\%-CI: 1.07-1.19). Age moderated the relationship between symptoms and anxiety (B\(_{urination}\) = -0.10, P = .02; B\(_{sexuality}\) = -0.11, P = .01). Conclusions Younger patients, those with metastases or treatment with chemotherapy seem to be at elevated risk for distress and should be closely monitored. Many patients suffer from disease-specific symptom burden, by which younger patients seem to be particularly distressed. Support of coping mechanisms associated with disease-specific symptom burden seems warranted.}, language = {en} } @article{OorschotIshiiKusomotoetal.2020, author = {Oorschot, Birgitt van and Ishii, Koji and Kusomoto, Yuko and Zetzl, Theresa and Roch, Carmen and Mettenleiter, Andreas and Ozawa, Hiroko and Flentje, Michael}, title = {Anxiety, depression and psychosocial needs are the most frequent concerns reported by patients: preliminary results of a comparative explorative analysis of two hospital-based palliative care teams in Germany and Japan}, series = {Journal of Neural Transmission}, volume = {127}, journal = {Journal of Neural Transmission}, issn = {0300-9564}, doi = {10.1007/s00702-020-02186-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235675}, pages = {1481-1489}, year = {2020}, abstract = {In the partnership between the medical departments of W{\"u}rzburg University, Germany, and Nagasaki University, Japan, palliative care is a relevant topic. The aim of the study was to perform a comparative analysis of the hospital-based palliative care teams in W{\"u}rzburg (PCT-W) and Nagasaki (PCT-N). Survey of staff composition and retrospective analysis of PCT patient charts in both PCTs were conducted. Patients self-assessed their symptoms in PCT-W and in Radiation Oncology W{\"u}rzburg (RO-W). The (negative) quality indicator 'percentage of deceased hospitalised patients with PCT contact for less than 3 days before death' (Earle in Int J Qual Health Care 17(6):505-509, 2005) was analysed. Both PCTs follow a multidisciplinary team approach. PCT-N saw 410 cancer patients versus 853 patients for PCT-W (22.8\% non-cancer patients). The Eastern Cooperative Oncology Group Performance Status at first contact with PCT-N was 3 or 4 in 39.3\% of patients versus 79.0\% for PCT-W. PCT-N was engaged in co-management longer than PCT-W (mean 20.7 days, range 1-102 versus mean 4.9 days, range 1-48). The most frequent patient-reported psychological symptom was anxiety (family anxiety: 98.3\% PCT-W and 88.7\% RO-W, anxiety 97.9\% PCT-W and 85.9\% RO-W), followed by depression (98.2\% PCT-W and 80.3\% RO-W). In 14 of the 148 deceased patients, PCT-N contact was initiated less than 3 days before death (9.4\%) versus 121 of the 729 deceased PCT-W patients (16.6\%). Psychological needs are highly relevant in both Germany and Japan, with more than 85\% anxiety and depression in patients in the Japanese IPOS validation study (Sakurai in Jpn J Clin Oncol 49(3):257-262, 2019). This should be taken into account when implementing PCTs.}, language = {en} } @article{RiedererterMeulen2020, author = {Riederer, Peter and ter Meulen, Volker}, title = {Coronaviruses: a challenge of today and a call for extended human postmortem brain analyses}, series = {Journal of Neural Transmission}, volume = {127}, journal = {Journal of Neural Transmission}, number = {9}, issn = {0300-9564}, doi = {10.1007/s00702-020-02230-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-314637}, pages = {1217-1228}, year = {2020}, abstract = {While there is abounding literature on virus-induced pathology in general and coronavirus in particular, recent evidence accumulates showing distinct and deleterious brain affection. As the respiratory tract connects to the brain without protection of the blood-brain barrier, SARS-CoV-2 might in the early invasive phase attack the cardiorespiratory centres located in the medulla/pons areas, giving rise to disturbances of respiration and cardiac problems. Furthermore, brainstem regions are at risk to lose their functional integrity. Therefore, long-term neurological as well as psychiatric symptomatology and eventual respective disorders cannot be excluded as evidenced from influenza-A triggered post-encephalitic Parkinsonism and HIV-1 triggered AIDS-dementia complex. From the available evidences for coronavirus-induced brain pathology, this review concludes a number of unmet needs for further research strategies like human postmortem brain analyses. SARS-CoV-2 mirroring experimental animal brain studies, characterization of time-dependent and region-dependent spreading behaviours of coronaviruses, enlightening of pathological mechanisms after coronavirus infection using long-term animal models and clinical observations of patients having had COVID-19 infection are calling to develop both protective strategies and drug discoveries to avoid early and late coronavirus-induced functional brain disturbances, symptoms and eventually disorders. To fight SARS-CoV-2, it is an urgent need to enforce clinical, molecular biological, neurochemical and genetic research including brain-related studies on a worldwide harmonized basis.}, language = {en} } @phdthesis{Schwarz2020, author = {Schwarz, Elisa}, title = {Psychische Belastung bei Patienten mit Multiplem Myelom vor autologer Stammzelltransplantation. Subanalyse von Zusammenh{\"a}ngen zwischen depressiven Symptomen und klinischen Variablen}, doi = {10.25972/OPUS-20546}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-205462}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2020}, abstract = {Bereits bestehende wissenschaftliche Literatur weist in pr{\"a}klinischen Ergebnissen darauf hin, dass das sympathische Nervensystem eine entscheidende Rolle bei der Mobilisierung von h{\"a}matopoetischen Stammzellen spielt. Mehrere Vorarbeiten lieferten Hinweise, dass psychischer Distress bei Stammzelltransplantation mit einem langsameren Anstieg der absoluten Leukozytenzahl w{\"a}hrend Aplasie einhergehen k{\"o}nnte. Die Dauer der Aplasie ist von klinischer Relevanz. In der vorliegenden Arbeit wurden Zusammenh{\"a}nge zwischen Distress in Form von depressiven Symptomen und h{\"a}matologischer Rekonstitution nach erster autologer Stammzelltransplantation bei Patienten mit Multiplem Myelom (n = 47) untersucht. Mit Hilfe des Fragebogens PHQ-9 wurden die Patienten mit Multiplem Myelom am Tag ihrer ersten autologen Stammzelltransplantation auf depressive Symptome gescreent. Patienten mit Multiplem Myelom wiesen ein hohes Maß an Distress auf. In der Stichprobe aus 47 konsekutiven Patienten lag bei 12 Patienten (26\%) Distress in Form von Symptomen einer Depression vor. Es ließ sich kein Zusammenhang zwischen psychischer Belastung und verl{\"a}ngerter h{\"a}matologischen Rekonstitution (r = 0.025; n = 37; p = 0.882) feststellen. Erstmalig wurde der Zusammenhang zwischen psychischer Belastung und klinischen Parametern w{\"a}hrend h{\"a}matologischer Rekonstitution untersucht. Dabei ergaben sich klinisch relevante Resultate. Es zeigte sich eine Tendenz mit einem gr{\"o}ßeren Bedarf an Erythrozytenkonzentraten bei Verdacht auf Depression (V = 0.387; p = 0.071). Nebenbefundlich ergab sich in der multivariaten Analyse der signifikante Zusammenhang, dass ein hohes molekulargenetisches Risiko mit einer gr{\"o}ßeren Anzahl an verabreichten Erythrozytenkonzentraten einhergeht (p = 0.046). Dar{\"u}ber hinaus ergab sich ein relevanter Zusammenhang zwischen Verdacht auf Depression nach PHQ-9 und Aufenthaltsdauer. Depressive Patienten waren demnach tendenziell k{\"u}rzer im Krankenhaus (r = -0.25; n = 47; p = 0.09).}, subject = {Psychoneuroimmunologie}, language = {de} }