TY  - JOUR
A1  - Bürger, Arne
A1  - Schoenfeld, Cornelia von
A1  - Scheiner, Christin
A1  - Seidel, Alexandra
A1  - Wasserscheid, Antonia
A1  - Gad, Doreya
A1  - Kittel-Schneider, Sarah
A1  - Romanos, Marcel
A1  - Reiter, Andrea M. F.
T1  - Universal prevention for non-suicidal self-injury in adolescents is scarce - A systematic review
JF  - Frontiers in Psychiatry
N2  - Non-suicidal self-injury (NSSI) during adolescence is a high-risk marker for the development and persistence of mental health problems and has been recognized as a significant public health problem. Whereas targeted prevention has indeed shown to be effective in reducing NSSI and improve mental health problems, access to such programs is limited. By face validity, universal prevention of NSSI seems an ideal starting point for a stepped-care model to circumvent a lack of resources in the medical care system. However, it is yet unclear how effective such approaches are. Here, we provide a summary of existing work on universal prevention of NSSI in adolescents younger than 21 years based on a systematic literature search. We found that only seven studies are available. None of the programs evaluated was found to be effective in reducing the incidence or frequency of NSSI. After providing a comprehensive summary of the existing work, we evaluate the fact that existing work primarily focusses on selected/targeted prevention and on psychoeducational methods. We derive implications for future directions in the field of universal prevention of NSSI.
KW  - non-suicidal self-injury
KW  - NSSI
KW  - emotion regulation
KW  - prevention
KW  - universal prevention
KW  - adolescence
KW  - mental health
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357490
VL  - 14
ER  - 
TY  - JOUR
A1  - McNeill, Rhiannon V.
A1  - Radtke, Franziska
A1  - Nieberler, Matthias
A1  - Koreny, Carolin
A1  - Chiocchetti, Andreas G.
A1  - Kittel-Schneider, Sarah
T1  - Generation of four human induced pluripotent stem cells derived from ADHD patients carrying different genotypes for the risk SNP rs1397547 in the ADHD-associated gene ADGRL3
JF  - Stem Cell Research
N2  - Single nucleotide polymorphisms (SNPs) in the ADGRL3 gene have been significantly associated with the development of ADHD, the aetiology of which remains poorly understood. The rs1397547 SNP has additionally been associated with significantly altered ADGRL3 transcription. We therefore generated iPSCs from two wild type ADHD patients, and two ADHD patients heterozygous for the risk SNP. With this resource we aim to facilitate further investigation into the complex and heterogenous pathology of ADHD. Furthermore, we demonstrate the feasibility of using magnetic activated cell sorting to allow the unbiased selection of fully reprogrammed iPSCs.
KW  - induced pluripotent stem cells
KW  - ADHD patients
KW  - risk SNP rs1397547
KW  - gene ADGRL3
KW  - iPSCs
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-350099
VL  - 67
ER  - 
TY  - JOUR
A1  - Hampf, Chantal
A1  - Scherf-Clavel, Maike
A1  - Weiß, Carolin
A1  - Klüpfel, Catherina
A1  - Stonawski, Saskia
A1  - Hommers, Leif
A1  - Lichter, Katharina
A1  - Erhardt-Lehmann, Angelika
A1  - Unterecker, Stefan
A1  - Domschke, Katharina
A1  - Kittel-Schneider, Sarah
A1  - Menke, Andreas
A1  - Deckert, Jürgen
A1  - Weber, Heike
T1  - Effects of anxious depression on antidepressant treatment response
JF  - International Journal of Molecular Sciences
N2  - Anxious depression represents a subtype of major depressive disorder and is associated with increased suicidality, severity, chronicity and lower treatment response. Only a few studies have investigated the differences between anxious depressed (aMDD) and non-anxious depressed (naMDD) patients regarding treatment dosage, serum-concentration and drug-specific treatment response. In our naturalistic and prospective study, we investigated whether the effectiveness of therapy including antidepressants (SSRI, SNRI, NaSSA, tricyclics and combinations) in aMDD patients differs significantly from that in naMDD patients. In a sample of 346 patients, we calculated the anxiety somatization factor (ASF) and defined treatment response as a reduction (≥50%) in the Hamilton Depression Rating Scale (HDRS)-21 score after 7 weeks of pharmacological treatment. We did not observe an association between therapy response and the baseline ASF-scores, or differences in therapy outcomes between aMDD and naMDD patients. However, non-responders had higher ASF-scores, and at week 7 aMDD patients displayed a worse therapy outcome than naMDD patients. In subgroup analyses for different antidepressant drugs, venlafaxine-treated aMDD patients showed a significantly worse outcome at week 7. Future prospective, randomized-controlled studies should address the question of a worse therapy outcome in aMDD patients for different psychopharmaceuticals individually.
KW  - pharmacotherapy
KW  - depressive disorder
KW  - anxious depression
KW  - anxiety
KW  - therapy response
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-355801
SN  - 1422-0067
VL  - 24
IS  - 24
ER  - 
TY  - JOUR
A1  - Kopf, Juliane
A1  - Glöckner, Stefan
A1  - Althen, Heike
A1  - Cevada, Thais
A1  - Schecklmann, Martin
A1  - Dresler, Thomas
A1  - Kittel-Schneider, Sarah
A1  - Reif, Andreas
T1  - Neural responses to a working memory task in acute depressed and remitted phases in bipolar patients
JF  - Brain Sciences
N2  - (1) Cognitive impairments such as working memory (WM) deficits are amongst the most common dysfunctions characterizing bipolar disorder (BD) patients, severely contributing to functional impairment. We aimed to investigate WM performance and associated brain activation during the acute phase of BD and to observe changes in the same patients during remission. (2) Frontal brain activation was recorded using functional near-infrared spectroscopy (fNIRS) during n-back task conditions (one-back, two-back and three-back) in BD patients in their acute depressive (n = 32) and remitted (n = 15) phases as well as in healthy controls (n = 30). (3) Comparison of BD patients during their acute phase with controls showed a trend (p = 0.08) towards lower dorsolateral prefrontal cortex (dlPFC) activation. In the remitted phase, BD patients showed lower dlPFC and ventrolateral prefrontal cortex (vlPFC) activation (p = 0.02) compared to controls. No difference in dlPFC and vlPFC activation between BD patients’ phases was found. (4) Our results showed decreased working memory performance in BD patients during the working memory task in the acute phase of disease. Working memory performance improved in the remitted phase of the disease but was still particularly attenuated for the more demanding conditions.
KW  - verbal n-back
KW  - fNIRS
KW  - prefrontal cortex
KW  - cognitive deficits
KW  - bipolar disorder
KW  - remitted/acute phase
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-313509
SN  - 2076-3425
VL  - 13
IS  - 5
ER  - 
TY  - JOUR
A1  - Leutritz, Anna Linda
A1  - van Braam, Lara
A1  - Preis, Katharina
A1  - Gehrmann, Andrea
A1  - Scherf-Clavel, Maike
A1  - Fiedler, Katrin
A1  - Unterecker, Stefan
A1  - Kittel-Schneider, Sarah
T1  - Psychotropic medication in pregnancy and lactation and early development of exposed children
JF  - British Journal of Clinical Pharmacology
N2  - There is still limited knowledge about alterations of blood concentrations of psychotropic drugs during pregnancy, the transfer of psychotropic drugs into breastmilk and the effects on exposed children. We investigated changes in concentrations of psychopharmacological medication during pregnancy and lactation in serum and breastmilk at different time points in a naturalistic sample of 60 mothers and observed the development of the exposed children in the first 12 months. We found a decrease in serum concentrations from the first to the second trimester of amitriptyline, duloxetine, escitalopram, quetiapine and sertraline. Citalopram stayed rather stable during pregnancy, sertraline levels interestingly increased again from the second to the third trimester. High concentration-by-dose ratios in breastmilk were found for venlafaxine as well as lamotrigine, low for quetiapine and clomipramine. Similarly, clomipramine and quetiapine showed low milk/serum–penetration ratios. Regarding the birth outcome measures in children, we found no significant differences between in utero exposed compared to nonexposed newborns. There were no significant differences in the development in the first 12 months. Psychotropic medication in the peripartum needs a balancing of risks and benefits and a continuous therapeutic drug monitoring can be a guidance for clinicians to monitor drug alteration patterns, which are likely to occur due to physiological pregnancy-associated changes in pharmacokinetics. Accordingly, therapeutic drug monitoring can optimize a medication in pregnancy and lactation with the lowest effective dose.
KW  - antidepressants
KW  - psychotropic medication
KW  - pregnancy
KW  - peripartum
KW  - mental disorders
KW  - lactation
KW  - child development
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-318954
VL  - 89
IS  - 2
SP  - 737
EP  - 750
ER  - 
TY  - JOUR
A1  - Gehrmann, Andrea
A1  - Fiedler, Katrin
A1  - Leutritz, Anna Linda
A1  - Koreny, Carolin
A1  - Kittel-Schneider, Sarah
T1  - Lithium medication in pregnancy and breastfeeding — a case series
JF  - Medicina
N2  - Lithium salts are the first-line prophylaxis treatment for bipolar disorder in most guidelines. The majority of bipolar women are treated with mood stabilizers at the time they wish to get pregnant. One reason for this is the rising average age at first childbirth, at least in the high-income countries, which increases in general the likelihood of a medication with psychotropic drugs. Previously, lithium exposition during pregnancy was thought to strongly increase the risk of severe cardiac malformation. However, recent studies only point to a low teratogenic risk, so nowadays an increasing number of women are getting pregnant with ongoing lithium treatment. Regarding lithium medication during breastfeeding, there is evidence that lithium transfers to the breastmilk and can also be detected in the infants' serum. The influence on the infant is still a largely understudied topic. Regular monitoring of the infants' renal clearance, thyroid function, and lithium levels is warranted when breastfeeding under lithium exposure. In this case series, we present three case reports of bipolar mothers who were treated with lithium during pregnancy and breastfeeding to add to the scarce literature on this important topic. In short, we strengthen the importance of therapeutic drug monitoring due to fluctuating plasma levels during pregnancy and after birth, and we can report the birth and development of three healthy infants despite lithium medication during pregnancy and breastfeeding.
KW  - lithium
KW  - pregnancy
KW  - lactation
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-285640
SN  - 1648-9144
VL  - 57
IS  - 6
ER  - 
TY  - JOUR
A1  - Janson, Patrick
A1  - Willeke, Kristina
A1  - Zaibert, Lisa
A1  - Budnick, Andrea
A1  - Berghöfer, Anne
A1  - Kittel-Schneider, Sarah
A1  - Heuschmann, Peter U.
A1  - Zapf, Andreas
A1  - Wildner, Manfred
A1  - Stupp, Carolin
A1  - Keil, Thomas
T1  - Mortality, morbidity and health-related outcomes in informal caregivers compared to non-caregivers: a systematic review
JF  - International Journal of Environmental Research and Public Health
N2  - A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following PRISMA recommendations, we searched major healthcare databases (CINAHL, MEDLINE and Web of Science) systematically for relevant studies published in the last 10 years (without language restrictions) (PROSPERO registration number: CRD42020200314). We included only observational cross-sectional and cohort studies with low risk of bias (risk scores 0–2 out of max 8) that reported the prevalence, incidence, odds ratio (OR), hazard ratio (HR), mean- or sum-scores for health-related outcomes in informal caregivers and non-caregivers. For a thorough methodological quality assessment, we used a validated checklist. The synthesis of the results was conducted by grouping outcomes. We included 22 studies, which came predominately from the USA and Europe. Informal caregivers had a significantly lower mortality than non-caregivers. Regarding chronic morbidity outcomes, the results from a large longitudinal German health-insurance evaluation showed increased and statistically significant incidences of severe stress, adjustment disorders, depression, diseases of the spine and pain conditions among informal caregivers compared to non-caregivers. In cross-sectional evaluations, informal caregiving seemed to be associated with a higher occurrence of depression and of anxiety (ranging from 4 to 51% and 2 to 38%, respectively), pain, hypertension, diabetes and reduced quality of life. Results from our systematic review suggest that informal caregiving may be associated with several mental and physical disorders. However, these results need to be interpreted with caution, as the cross-sectional studies cannot determine temporal relationships. The lower mortality rates compared to non-caregivers may be due to a healthy-carer bias in longitudinal observational studies; however, these and other potential benefits of informal caregiving deserve further attention by researchers.
KW  - cohort studies
KW  - longitudinal studies
KW  - cross-sectional studies
KW  - family caregivers
KW  - informal caregiving
KW  - mental health
KW  - physical health
KW  - population-based studies
KW  - systematic review
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-275219
SN  - 1660-4601
VL  - 19
IS  - 10
ER  - 
TY  - JOUR
A1  - Brunkhorst-Kanaan, Nathalie
A1  - Trautmann, Sandra
A1  - Schreiber, Yannick
A1  - Thomas, Dominique
A1  - Kittel-Schneider, Sarah
A1  - Gurke, Robert
A1  - Geisslinger, Gerd
A1  - Reif, Andreas
A1  - Tegeder, Irmgard
T1  - Sphingolipid and endocannabinoid profiles in adult attention deficit hyperactivity disorder
JF  - Biomedicines
N2  - Genes encoding endocannabinoid and sphingolipid metabolism pathways were suggested to contribute to the genetic risk towards attention deficit hyperactivity disorder (ADHD). The present pilot study assessed plasma concentrations of candidate endocannabinoids, sphingolipids and ceramides in individuals with adult ADHD in comparison with healthy controls and patients with affective disorders. Targeted lipid analyses of 23 different lipid species were performed in 71 mental disorder patients and 98 healthy controls (HC). The patients were diagnosed with adult ADHD (n = 12), affective disorder (major depression, MD n = 16 or bipolar disorder, BD n = 6) or adult ADHD with comorbid affective disorders (n = 37). Canonical discriminant analysis and CHAID analyses were used to identify major components that predicted the diagnostic group. ADHD patients had increased plasma concentrations of sphingosine-1-phosphate (S1P d18:1) and sphinganine-1-phosphate (S1P d18:0). In addition, the endocannabinoids, anandamide (AEA) and arachidonoylglycerol were increased. MD/BD patients had increased long chain ceramides, most prominently Cer22:0, but low endocannabinoids in contrast to ADHD patients. Patients with ADHD and comorbid affective disorders displayed increased S1P d18:1 and increased Cer22:0, but the individual lipid levels were lower than in the non-comorbid disorders. Sphingolipid profiles differ between patients suffering from ADHD and affective disorders, with overlapping patterns in comorbid patients. The S1P d18:1 to Cer22:0 ratio may constitute a diagnostic or prognostic tool.
KW  - attention deficit hyperactivity disorder
KW  - endocannabinoids
KW  - ceramides
KW  - bipolar disorder
KW  - major depression
KW  - tandem mass spectrometry
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-246080
SN  - 2227-9059
VL  - 9
IS  - 9
ER  - 
TY  - JOUR
A1  - Willeke, Kristina
A1  - Janson, Patrick
A1  - Zink, Katharina
A1  - Stupp, Carolin
A1  - Kittel-Schneider, Sarah
A1  - Berghöfer, Anne
A1  - Ewert, Thomas
A1  - King, Ryan
A1  - Heuschmann, Peter U.
A1  - Zapf, Andreas
A1  - Wildner, Manfred
A1  - Keil, Thomas
T1  - Occurrence of mental illness and mental health risks among the self-employed: a systematic review
JF  - International Journal of Environmental Research and Public Health
N2  - We aimed to systematically identify and evaluate all studies of good quality that compared the occurrence of mental disorders in the self-employed versus employees. Adhering to the Cochrane guidelines, we conducted a systematic review and searched three major medical databases (MEDLINE, Web of Science, Embase), complemented by hand search. We included 26 (three longitudinal and 23 cross-sectional) population-based studies of good quality (using a validated quality assessment tool), with data from 3,128,877 participants in total. The longest of these studies, a Swedish national register evaluation with 25 years follow-up, showed a higher incidence of mental illness among the self-employed compared to white-collar workers, but a lower incidence compared to blue-collar workers. In the second longitudinal study from Sweden the self-employed had a lower incidence of mental illness compared to both blue- and white-collar workers over 15 years, whereas the third longitudinal study (South Korea) did not find a difference regarding the incidence of depressive symptoms over 6 years. Results from the cross-sectional studies showed associations between self-employment and poor general mental health and stress, but were inconsistent regarding other mental outcomes. Most studies from South Korea found a higher prevalence of mental disorders among the self-employed compared to employees, whereas the results of cross-sectional studies from outside Asia were less consistent. In conclusion, we found evidence from population-based studies for a link between self-employment and increased risk of mental illness. Further longitudinal studies are needed examining the potential risk for the development of mental disorders in specific subtypes of the self-employed.
KW  - incidence
KW  - mental disorders
KW  - mental health
KW  - mental illness
KW  - prevalence
KW  - self-employed
KW  - small business
KW  - systematic review
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-245085
SN  - 1660-4601
VL  - 18
IS  - 16
ER  - 
TY  - JOUR
A1  - Kittel-Schneider, Sarah
A1  - Felice, Ethel
A1  - Buhagiar, Rachel
A1  - Lambregtse-van den Berg, Mijke
A1  - Wilson, Claire A.
A1  - Banjac Baljak, Visnja
A1  - Vujovic, Katarina Savic
A1  - Medic, Branislava
A1  - Opankovic, Ana
A1  - Fonseca, Ana
A1  - Lupattelli, Angela
T1  - Treatment of peripartum depression with antidepressants and other psychotropic medications: a synthesis of clinical practice guidelines in Europe
JF  - International Journal of Environmental Research and Public Health
N2  - This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers' compliance to the guidelines. We conducted a search using Medline and the Guidelines International Network database, combined with direct e-mail contact with national Riseup-PPD COST ACTION members and researchers within psychiatry. Of the 48 European countries examined, we screened 41 records and included 14 of them for full-text evaluation. After exclusion of ineligible and duplicate records, we included 12 CPGs. Multiple CPGs recommend antidepressant initiation or continuation based on maternal disease severity, non-response to first-line non-pharmacological interventions, and after risk-benefit assessment. Advice on treatment of comorbid anxiety is largely missing or unspecific. Antidepressant dispensing data suggest general prescribers' compliance with the preferred substances of the CPG, although country-specific differences were noted. To conclude, there is an urgent need for harmonized, up-to-date CPGs for pharmacological management of peripartum depression and comorbid anxiety in Europe. The recommendations need to be informed by the latest available evidence so that healthcare providers and women can make informed, evidence-based decisions about treatment choices.
KW  - clinical practice guideline
KW  - depression
KW  - anxiety
KW  - antidepressant
KW  - psychotropic medications
KW  - peripartum
Y1  - 2022
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-262130
SN  - 1660-4601
VL  - 19
IS  - 4
ER  -