@article{FreyLeutritzBackhausetal.2022,
  author    = {Frey, Anna and Leutritz, Tobias and Backhaus, Joy and H{\"o}rnlein, Alexander and K{\"o}nig, Sarah},
  title     = {Item format statistics and readability of extended matching questions as an effective tool to assess medical students},
  series = {Scientific Reports},
  volume    = {12},
  journal   = {Scientific Reports},
  number    = {1},
  doi       = {10.1038/s41598-022-25481-y},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-300485},
  year      = {2022},
  abstract  = {Testing based on multiple choice questions (MCQ) is one of the most established forms of assessment, not only in the medical field. Extended matching questions (EMQ) represent a specific type of MCQ designed to require higher levels of cognition, such as problem-solving. The purpose of this evaluation was to assess the suitability and efficiency of EMQ as an assessment method. EMQ were incorporated into the end-of-semester examination in internal medicine, in which 154 students participated, and compared with three established MCQ types. Item and examination quality were investigated, as well as readability and processing time. EMQ were slightly more difficult to score; however, both item discrimination and discrimination index were higher when compared to other item types. EMQ were found to be significantly longer and required more processing time, but readability was improved. Students judged EMQ as clearly challenging, but attributed significantly higher clinical relevance when compared to established MCQ formats. Using the Spearman-Brown prediction, only ten EMQ items would be needed to reproduce the Cronbach's alpha value of 0.75 attained for the overall examination. EMQ proved to be both efficient and suitable when assessing medical students, demonstrating powerful characteristics of reliability. Their expanded use in favor of common MCQ could save examination time without losing out on statistical quality.},
  language  = {en}
}
@article{KittelSchneiderDavidovaKaloketal.2022,
  author    = {Kittel-Schneider, Sarah and Davidova, Petra and Kalok, Miriam and Essel, Corina and Ahmed, Fadia Ben and Kingeter, Yasmina and Matentzoglu, Maria and Leutritz, Anna and Kersken, Katharina and Koreny, Carolin and Weber, Heike and Kollert, Leoniee and McNeill, Rihannon V. and Reif, Andreas and Bahlmann, Franz and Trautmann-Villalba, Patricia},
  title     = {A pilot study of multilevel analysis of BDNF in paternal and maternal perinatal depression},
  series = {Archives of Women's Mental Health},
  volume    = {25},
  journal   = {Archives of Women's Mental Health},
  number    = {1},
  issn      = {1435-1102},
  doi       = {10.1007/s00737-021-01197-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-268849},
  pages     = {237-249},
  year      = {2022},
  abstract  = {Depression in the perinatal period is common in mothers worldwide. Emerging research indicates that fathers are also at risk of developing perinatal depression. However, knowledge regarding biological risk factors and pathophysiological mechanisms of perinatal depression is still scarce, particularly in fathers. It has been suggested that the neurotrophin BDNF may play a role in maternal perinatal depression; however, there is currently no data regarding paternal perinatal depression. For this pilot study, 81 expecting parents were recruited and assessed at several time points. We screened for depression using EPDS and MADRS, investigated several psychosocial variables, and took blood samples for BDNF val66met genotyping, epigenetic, and protein analysis. Between pregnancy and 12 months postpartum (pp), we found that 3.7 to 15.7\% of fathers screened positive for depression, and 9.6 to 24\% of mothers, with at least a twofold increased prevalence in both parents using MADRS compared with EPDS. We also identified several psychosocial factors associated with perinatal depression in both parents. The data revealed a trend that lower BDNF levels correlated with maternal depressive symptoms at 3 months pp. In the fathers, no significant correlations between BDNF and perinatal depression were found. Pregnant women demonstrated lower BDNF methylation and BDNF protein expression compared with men; however, these were found to increase postpartum. Lastly, we identified correlations between depressive symptoms and psychosocial/neurobiological factors. The data suggest that BDNF may play a role in maternal perinatal depression, but not paternal.},
  language  = {en}
}
@article{GehrmannFiedlerLeutritzetal.2021,
  author    = {Gehrmann, Andrea and Fiedler, Katrin and Leutritz, Anna Linda and Koreny, Carolin and Kittel-Schneider, Sarah},
  title     = {Lithium medication in pregnancy and breastfeeding — a case series},
  series = {Medicina},
  volume    = {57},
  journal   = {Medicina},
  number    = {6},
  issn      = {1648-9144},
  doi       = {10.3390/medicina57060634},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-285640},
  year      = {2021},
  abstract  = {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.},
  language  = {en}
}
@article{LeutritzvanBraamPreisetal.2023,
  author    = {Leutritz, Anna Linda and van Braam, Lara and Preis, Katharina and Gehrmann, Andrea and Scherf-Clavel, Maike and Fiedler, Katrin and Unterecker, Stefan and Kittel-Schneider, Sarah},
  title     = {Psychotropic medication in pregnancy and lactation and early development of exposed children},
  series = {British Journal of Clinical Pharmacology},
  volume    = {89},
  journal   = {British Journal of Clinical Pharmacology},
  number    = {2},
  doi       = {10.1111/bcp.15533},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-318954},
  pages     = {737 -- 750},
  year      = {2023},
  abstract  = {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.},
  language  = {en}
}