@phdthesis{Posch2022,
  author    = {Posch, Ines Juliane},
  title     = {Die retrospektive Beurteilung station{\"a}rer kinder- und jugendpsychiatrischer Behandlung nach 10 Jahren - Eine Nachbefragung ehemaliger Patienten der Klinik f{\"u}r Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie des Universit{\"a}tsklinikums W{\"u}rzburg},
  doi       = {10.25972/OPUS-28313},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-283135},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2022},
  abstract  = {Fragestellung: P{\"a}dagogische und medizinische Institutionen betreuen Kinder und Jugendliche, um Aufsicht, Beschulung, Erziehung, Therapie und Schutz sicherzustellen. Gleichwohl sind Kinder in institutioneller Betreuung potentiellen Gef{\"a}hrdungsmomenten bez{\"u}glich Misshandlung und Missbrauch ausgesetzt. Methodik: Im Rahmen der Etablierung des Schutzkonzeptes der Klinik f{\"u}r Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie am Universit{\"a}tsklinikum W{\"u}rzburg wurde eine retrospektive Patientenbefragung durchgef{\"u}hrt. Das Untersuchungskollektiv bildeten alle ehemaligen station{\"a}ren Patientinnen und Patienten der Jahre 2006 und 2007, die zum Katamnesezeitpunkt vollj{\"a}hrig waren. Die Befragung erfolgte postalisch. Der Fragebogen umfasste neben Items zum Kontext von Gewalterfahrungen etablierte Skalen zur Erfassung von Behandlungszufriedenheit und Lebensqualit{\"a}t (FBB-K, WHO-BREF). Ergebnisse: Von 568 ehemaligen Patientinnen und Patienten gaben 87 (15.3 \%) eine g{\"u}ltige R{\"u}ckantwort (59 weiblich, durchschnittliches Alter zum Befragungszeitpunkt: 24.5 Jahre). 35 ehemalige Patientinnen und Patienten (40.2 \% der Teilnehmenden) gaben an, Gewalt w{\"a}hrend der station{\"a}ren Behandlung erlebt (n=26) oder erlebt und ausge{\"u}bt (n=7) oder ausschließlich ausge{\"u}bt (n=2) zu haben. Gewalterfahrungen beinhalteten in den meisten F{\"a}llen emotionale Gewalt (34.5 \%), aber auch k{\"o}rperliche (5.7 \%) und sexuelle Gewalt (10.3 \%). Schlussfolgerung: Es zeigt sich ein signifikanter Zusammenhang zwischen Gewalterfahrungen einerseits sowie retrospektiver Behandlungszufriedenheit und aktueller Lebensqualit{\"a}t andererseits. Die Ergebnisse der Befragung unterstreichen die Bedeutung der Etablierung von Schutzkonzepten in Kliniken und anderen Institutionen.},
  subject      = {Kinder- und Jugendpsychiatrie},
  language  = {de}
}
@phdthesis{PreussWiedenhoff2017,
  author    = {Preuß-Wiedenhoff, Andrea},
  title     = {Therapeutisches Drug Monitoring bei an Schizophrenie erkrankten Kindern und Jugendlichen unter Pharmakotherapie mit Risperidon},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-156176},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2017},
  abstract  = {Ziel: Das Ziel dieser retrospektiven, naturalistischen Studie ist zum einen die Untersuchung der Zusammenh{\"a}nge von Dosierung und Serumkonzentration, Serumkonzentration und Therapieeffekt sowie von Serumkonzentration und unerw{\"u}nschten Arzneimittel-Wirkungen (UAW) bei an Schizophrenie erkrankten Kindern und Jugendlichen unter Risperidon-Therapie. Zum anderen soll die Anwendbarkeit des therapeutischen Serumkonzentrations-Referenzbereichs von Erwachsenen f{\"u}r Kinder und Jugendliche untersucht werden. Methode: Die von mehreren Kliniken in den Jahren 2005 - 2009 erhobenen Daten von 40 Kindern und Jugendlichen, die mittels des Therapeutischen Drug Monitorings {\"u}berwacht wurden, wurden retrospektiv ausgewertet. Die gemessenen Serumkonzentrationen erfolgten im Steady State und beziehen sich auf die Summe von Risperidon und 9-hydroxy-Risperidon (aktive Menge). Die Beurteilung der Therapieeffekte erfolgte mittels der CGI-C-Unterskala (Clinical Global Impression of Change), die der UAW mithilfe der UKU-Skala (Udvalg for Kliniske Unders{\o}gelser). Ergebnis und Fazit: Es zeigt sich eine signifikante, positive Korrelation zwischen der Tagesdosierung und der Serumkonzentration und keine signifikante Korrelation zwischen der Serumkonzentration und dem Therapieeffekt bzw. den UAW. Die Ergebnisse dieser Arbeit liefern erste Hinweise f{\"u}r einen m{\"o}glicherweise niedrigeren therapeutischen Referenzbereich f{\"u}r an Schizophrenie erkrankten Kindern und Jugendlichen unter Risperidon-Behandlung. Aufgrund der Limitationen des naturalistischen Studiendesigns ist der vorgeschlagene Referenzbereich eine richtungsweisende Empfehlung. Weitere Studien mit gr{\"o}ßeren Stichprobenzahlen sind n{\"o}tig um diese Ergebnisse zu validieren.},
  subject      = {Arzneimittel{\"u}berwachung},
  language  = {de}
}
@phdthesis{Reefschlaeger2018,
  author    = {Reefschl{\"a}ger, Lennart Gunnar},
  title     = {Expressionsanalysen monoaminerger Kandidatengene bei der Aufmerksamkeitsdefizit-/Hyperaktivit{\"a}tsst{\"o}rung und Autismusspektrumsst{\"o}rung},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-162371},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2018},
  abstract  = {Objectives. In absence of objective clinical characteristics the identification of peripheral biomarkers in neuropsychiatric disorders is highly relevant for the diagnostic process and an individualized therapy. We analyzed mRNA-expression of monoaminergic candidate genes (DRD4, DRD5, TPH1) in peripheral tissue of patients with attention deficit hyperactivity disorder (ADHD) and autism spectrum disorders (ASD), highly comorbid with ADHD, searching for possible molecular markers for these disorders. Methods. mRNA was obtained from children and adolescents with ADHD (n = 51) and ASD (n = 26), diagnosed according to ICD-10 criteria, as well as healthy controls (n = 39). mRNA expression was determined via quantitative realtime PCR (qRT-PCR) from whole blood cells. Results. The concentrations of DRD4-mRNA in the whole blood were significantly lower in ADHD and ASD children (19 of 26 comorbid with ADHD) compared to healthy controls. ASD patients revealed a significantly decreased DRD5 mRNA expression in comparison to the two other groups. Conclusions. Alterations in mRNA expression patterns provide further evidence for a relevant effect of the respective candidate genes in the pathophysiology of ADHD. Given their potential as biomarkers mRNA expression patterns may be useful tools in (differential-) diagnostic procedures of ADHD and ASD. Future studies may determine the sensitivity and specificity of these putative biomarkers in larger samples including further neuropsychiatric diagnoses.},
  language  = {de}
}
@phdthesis{Renner2007,
  author    = {Renner, Tobias Johann},
  title     = {Die Nogo-Anteriorisierung bei gesunden und zwangserkrankten Kindern und Jugendlichen},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-22778},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2007},
  abstract  = {In der vorliegenden Studie wurden erstmals Kinder und Jugendliche mit Zwangsst{\"o}rungen in Hinblick auf eine ver{\"a}nderte Aktivierung von anteriorem cingul{\"a}rem Cortex (ACC) und pr{\"a}frontalen Arealen elektrophysiologisch untersucht. Zur Durchf{\"u}hrung der Studie wurde als Paradigma ein cued Continuous Performance Test (cCPT) mit Aufgabenstellung zu Exekution und Inhibition vorbereiteter motorischer Reaktionen gew{\"a}hlt. In der Auswertung der Daten lag ein besonderer Schwerpunkt auf der Nogo-Anteriorisierung (NGA), die in der topographischen Analyse des ereigniskorrelierten Potentials P300 speziell die Aktivierung von ACC und pr{\"a}frontalen Arealen erfasst. Um Vergleichswerte von gesunden Kindern und Jugendlichen zu erhalten und zugleich die NGA als elektrophysiologischen Parameter f{\"u}r das Kindes- und Jugendalter in Hinblick auf Auftreten und Beeinflussung durch Alter und Geschlecht zu validieren, wurden gesunde Probanden im Alter von 10 bis 17 Jahren mit einem ausgewogenem Verh{\"a}ltnis der Geschlechter mit dem identischen Studiensetting untersucht. Dabei konnte erstmals f{\"u}r ein kontinuierliches Altersspektrum f{\"u}r Kinder und Jugendliche gezeigt werden, dass die NGA bei {\"a}lteren Kindern und Jugendlichen als stabiler elektrophysiologischer Parameter auftritt und zur Untersuchung von hirnelektrischer Aktivierung bei psychiatrisch erkrankten Kindern und Jugendlichen qualifiziert. In {\"U}bereinstimmung mit den Daten von Erwachsenen ergab sich kein geschlechtsspezifischer Einfluss; auch die mit dem Lebensalter zunehmende Frontalisierung der hirnelektrischen Aktivierung konnte f{\"u}r Kinder und Jugendliche nachvollzogen werden. Die Ergebnisse f{\"u}r j{\"u}ngere Kinder, die nicht durchg{\"a}ngig eine NGA aufweisen, sind kongruent zu Vorbefunden und k{\"o}nnten einen Hinweis auf eine entwicklungsabh{\"a}ngige Ausbildung der NGA sein. Der Vergleich der Daten von Kindern und Jugendlichen mit Zwangsst{\"o}rungen mit gesunden Gleichaltrigen zeigte keine signifikanten Unterschiede in der Auspr{\"a}gung der NGA, die Hypothese einer differierenden Aktivierung von ACC und pr{\"a}frontalen Arealen ist demnach nicht best{\"a}tigt. Unterschiede ergaben sich in den Verhaltensdaten, hier wiesen die Kinder und Jugendlichen mit Zwangsst{\"o}rungen mehr falsche positive Fehler auf. Ebenfalls ver{\"a}ndert war die Latenz der P300 f{\"u}r die Bedingung Go, die f{\"u}r die Patientengruppe verl{\"a}ngert war. Aus diesen Daten ergeben sich Hinweise auf eine ver{\"a}nderte initiale Informationsverarbeitung bei Kindern und Jugendlichen mit Zwangsst{\"o}rungen in Aufgaben zu motorischer Reaktion. Eine weitere Schlussfolgerung dieser Studie geht aus den deutlichen Unterschieden zu den Daten von erwachsenen Probanden mit Zwangsst{\"o}rungen hervor. W{\"a}hrend bei den gesunden Kindern und Jugendlichen eine Entwicklung hin zu den Daten gesunder Erwachsener gezeigt werden konnte, weisen die differierenden Daten bei den Patienten mit Zwangsst{\"o}rungen auf abweichende neurophysiologische Abl{\"a}ufe hin, wodurch die Hypothese einer f{\"u}r das Kindes- und Jugendalter spezifischen Pathophysiologie bei Zwangsst{\"o}rungen gest{\"u}tzt und der weitere Bedarf an eigenst{\"a}ndigen Studien mit Kindern und Jugendlichen zu psychiatrischen Erkrankungen unterstrichen wird.},
  language  = {de}
}
@article{ReuterJaeckelsKneitzetal.2019,
  author    = {Reuter, Isabel and J{\"a}ckels, Jana and Kneitz, Susanne and Kuper, Jochen and Lesch, Klaus-Peter and Lillesaar, Christina},
  title     = {Fgf3 is crucial for the generation of monoaminergic cerebrospinal fluid contacting cells in zebrafish},
  series = {Biology Open},
  volume    = {8},
  journal   = {Biology Open},
  doi       = {10.1242/bio.040683},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-200749},
  pages     = {bio040683},
  year      = {2019},
  abstract  = {In most vertebrates, including zebrafish, the hypothalamic serotonergic cerebrospinal fluid-contacting (CSF-c) cells constitute a prominent population. In contrast to the hindbrain serotonergic neurons, little is known about the development and function of these cells. Here, we identify fibroblast growth factor (Fgf)3 as the main Fgf ligand controlling the ontogeny of serotonergic CSF-c cells. We show that fgf3 positively regulates the number of serotonergic CSF-c cells, as well as a subset of dopaminergic and neuroendocrine cells in the posterior hypothalamus via control of proliferation and cell survival. Further, expression of the ETS-domain transcription factor etv5b is downregulated after fgf3 impairment. Previous findings identified etv5b as critical for the proliferation of serotonergic progenitors in the hypothalamus, and therefore we now suggest that Fgf3 acts via etv5b during early development to ultimately control the number of mature serotonergic CSF-c cells. Moreover, our analysis of the developing hypothalamic transcriptome shows that the expression of fgf3 is upregulated upon fgf3 loss-of-function, suggesting activation of a self-compensatory mechanism. Together, these results highlight Fgf3 in a novel context as part of a signalling pathway of critical importance for hypothalamic development.},
  language  = {en}
}
@phdthesis{Schaeff2021,
  author    = {Schaeff, Sulamith},
  title     = {Correlates of Substantia Nigra Echogenicity in Healthy Children},
  doi       = {10.25972/OPUS-23074},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-230747},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Objective: Substantia nigra hyperechogenicity is found in children with attention- deficit hyperactivity disorder (ADHD). Research with transcranial sonography (TCS) in adults suggests that echogenic alterations are linked to subclinical behavioral deficits and that brain iron homeostasis is involved in the signal genesis. The purpose of this study was to explore substantia nigra echogenicity in healthy children, to assess age-related changes and to investigate whether echogenic signals relate to subclinical alterations in behavior. Furthermore, associations of central nigral neuromelanin measures and peripheral serum iron parameters to echogenic signals of the substantia nigra were evaluated. Methods: In a multimodal study design, neuroimaging of the substantia nigra was conducted with TCS and neuromelanin-sensitive magnetic resonance imaging (MRI) in 28 healthy children (8 - 12 years). Correlations and multiple regression analyses determined associations between the neuroimaging methods, behavioral data from Strength and Difficulties Questionnaire (SDQ) and serum iron-related parameters. Results: Substantia nigra echogenicity correlated inversely with hyperactivity ratings in healthy, non-ADHD children (r = -.602, p = .001). Echogenic sizes did not change as a function of age. Neuromelanin-sensitive MRI measures of the substantia nigra and peripheral serum iron parameters were not associated with nigral TCS signals. Conclusion: In healthy children behavioral differences in hyperactive tendencies are associated with differences in substantia nigra echogenicity. This could help to identify those children who are at risk of subclinical ADHD.},
  subject      = {Substantia nigra},
  language  = {en}
}
@article{ScheinerDaunkeSeideletal.2023,
  author    = {Scheiner, Christin and Daunke, Andrea and Seidel, Alexandra and Mittermeier, Sabrina and Romanos, Marcel and K{\"o}lch, Michael and Buerger, Arne},
  title     = {LessStress - how to reduce stress in school: evaluation of a universal stress prevention in schools: study protocol of a cluster-randomised controlled trial},
  series = {Trials},
  volume    = {24},
  journal   = {Trials},
  number    = {1},
  doi       = {10.1186/s13063-022-06970-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300393},
  year      = {2023},
  abstract  = {Background Chronic stress is detrimental to health, and children and young people have had to cope with significantly more stress since the start of the COVID-19 pandemic. In particular, stress at school and in relation to learning is a major problem in this age group. Studies in Germany have indicated that the pandemic has led to a reduced quality of life (QoL) and an increased risk for psychiatric disorders in children and adolescents. Schools are an ideal setting for interventions against stress, which is one of the strongest predictors for the development of psychosocial problems. The present study seeks to address stress by means of a short prevention training programme in schools, including emotion regulation, mindfulness, and self-compassion. In addition to information material for self-study, students should have the opportunity to actively deal with the topic of stress and develop coping strategies within a short space of time. In contrast to very long stress reduction programmes that often last several weeks, the programme is delivered in just 90 min. Methods The effectiveness of the short and economical prevention programme LessStress will be examined in a cluster-randomised controlled trial (RCT) encompassing 1894 students. At several measurement time points, students from two groups (intervention and control) will be asked about their subjectively perceived stress levels, among other aspects. Due to the clustered nature of the data, mainly multilevel analyses will be performed. Discussion In Germany, there are no nationwide universal prevention programmes for students against stress in schools, and this gap has become more evident since the outbreak of the pandemic. Universal stress prevention in schools may be a starting point to promote resilience. By dealing with stress in a healthy way, mental health can be strengthened and maintained. Moreover, to reach at-risk students at an early stage, we advocate for a stronger networking between child psychiatry and schools.},
  language  = {en}
}
@article{ScheinerGrashoffKleindienstetal.2022,
  author    = {Scheiner, Christin and Grashoff, Jan and Kleindienst, Nikolaus and Buerger, Arne},
  title     = {Mental disorders at the beginning of adolescence: Prevalence estimates in a sample aged 11-14 years},
  series = {Public Health in Practice},
  volume    = {4},
  journal   = {Public Health in Practice},
  doi       = {10.1016/j.puhip.2022.100348},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300404},
  year      = {2022},
  abstract  = {Objectives This study aims to provide a deeper insight into mental disorders in early adolescence. We report prevalence rates (mental health problems, depressive symptoms, eating disorders, NSSI, STBs) to be used in future studies and clinical ventures. We also expected to find gender differences, with girls being be more affected than boys are. Study design 877 adolescents (M = 12.43, SD = 0.65) from seven German high schools completed a series of questionnaires assessing their mental health (SDQ, PHQ-9, SEED, DSHI-9, Paykel Suicide Scale, FAS III). Methods We calculated cut-off-based prevalence estimates for mental health issues for the whole sample and compared estimates between genders. Results 12.5\% of the sample reported general mental health problems. The estimated prevalence of depressive symptoms lay at of 11.5\%. Additionally, 12.1\% and 1.3\% of the participants displayed relevant symptoms of anorexia or bulimia nervosa, respectively. A total of 10.8\% reported engaging in non-suicidal self-injury (NSSI) at least once in their lifetime, of whom 5.6\% reported repetitive NSSI. 30.1\% of the participants described suicidal thoughts, 9.9\% suicide plans, and 3.5\% at least one suicide attempt. Girls were generally more affected than boys, except for bulimia nervosa, suicidal behavior, and partly NSSI. Conclusion Our findings corroborate the established relevance of early adolescence for the development of mental health problems and suggest that a substantial proportion of young adolescents suffer from such problems early on. Considering the ongoing COVID-19 pandemic and reported negative mental health consequences, the current findings underline the importance of preventive interventions to avoid the manifestation of mental disorders during adolescence.},
  language  = {en}
}
@article{ScheinerSeisKleindienstetal.2023,
  author    = {Scheiner, Christin and Seis, Christian and Kleindienst, Nikolaus and Buerger, Arne},
  title     = {Psychopathology, protective factors, and COVID-19 among adolescents: a structural equation model},
  series = {International Journal of Environmental Research and Public Health},
  volume    = {20},
  journal   = {International Journal of Environmental Research and Public Health},
  number    = {3},
  issn      = {1660-4601},
  doi       = {10.3390/ijerph20032493},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-304475},
  year      = {2023},
  abstract  = {Since the outbreak of the COVID-19 pandemic in December 2019 and the associated restrictions, mental health in children and adolescents has been increasingly discussed in the media. Negative impacts of the pandemic, including a sharp increase in psychopathology and, consequently, reduced quality of life, appear to have particularly affected children and young people, who may be especially vulnerable to the adverse effects of isolation. Nevertheless, many children and adolescents have managed to cope well with the restrictions, without deterioration of their mental health. The present study therefore explored the links between COVID-19 infection (in oneself or a family member, as well as the death of a family member due to the virus), protective factors such as self-efficacy, resilience, self-esteem, and health-related quality of life, and measures of psychopathology such as depression scores, internalizing/externalizing problems, emotion dysregulation, and victimization. For this purpose, we examined data from 2129 adolescents (mean age = 12.31, SD = 0.67; 51\% male; 6\% born outside of Germany) using a structural equation model. We found medium to high loadings of the manifest variables with the latent variables (COVID-19, protective factors, and psychopathology). Protective factors showed a significant negative correlation with psychopathology. However, COVID-19 had a weak connection with psychopathology in our sample. External pandemic-related factors (e.g., restrictions) and their interaction with existing psychopathology or individual protective factors appear to have a greater influence on young people's mental health than the impact of the virus per se. Sociopolitical efforts should be undertaken to foster prevention and promote individual resilience, especially in adolescence.},
  language  = {en}
}
@article{SchieleReinhardReifetal.2016,
  author    = {Schiele, Miriam A. and Reinhard, Julia and Reif, Andreas and Domschke, Katharina and Romanos, Marcel and Deckert, J{\"u}rgen and Pauli, Paul},
  title     = {Developmental aspects of fear: Comparing the acquisition and generalization of conditioned fear in children and adults},
  series = {Developmental Psychobiology},
  volume    = {58},
  journal   = {Developmental Psychobiology},
  number    = {4},
  doi       = {10.1002/dev.21393},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-189488},
  pages     = {471-481},
  year      = {2016},
  abstract  = {Most research on human fear conditioning and its generalization has focused on adults whereas only little is known about these processes in children. Direct comparisons between child and adult populations are needed to determine developmental risk markers of fear and anxiety. We compared 267 children and 285 adults in a differential fear conditioning paradigm and generalization test. Skin conductance responses (SCR) and ratings of valence and arousal were obtained to indicate fear learning. Both groups displayed robust and similar differential conditioning on subjective and physiological levels. However, children showed heightened fear generalization compared to adults as indexed by higher arousal ratings and SCR to the generalization stimuli. Results indicate overgeneralization of conditioned fear as a developmental correlate of fear learning. The developmental change from a shallow to a steeper generalization gradient is likely related to the maturation of brain structures that modulate efficient discrimination between danger and (ambiguous) safety cues.},
  language  = {en}
}