1,720,979 research outputs found
Emotional distress in medical students in the context of university teaching on mental disorders
No full textZusammenfassung Hintergrund Zahlreiche Studien belegen eine hohe Ausprägung sowie Zunahme stressassoziierter Symptome und depressionsähnlicher Beschwerden bei Studierenden. Im Rahmen der Lehre zu psychischen Erkrankungen an unserer medizinischen Fakultät berichteten Studierende wiederholt emotional belastende Situationen und äußerten den Wunsch nach Unterstützungsangeboten. Ziel der vorliegenden Studie war die Objektivierung des Belastungslevels und des Bedarfs nach Unterstützungsangeboten. Material und Methoden Insgesamt 118 Studierende des 9. Semesters (WiSe 22/23) wurden mittels Fragebogen zu ihrer emotionalen Belastung befragt. Der Fragebogen wurde als Onlinebefragung in LimeSurvey (LimeSurvey GmbH, Hamburg, Deutschland) durchgeführt und enthielt insgesamt 18 als Statements formulierte sowie weitere Items. Zu den einzelnen Items konnten die Studierenden auf 11-stufigen numerischen Skalen mit Außenankern Ratings abgeben. Ergebnisse Die eigene Belastung im Vergleich zu anderen Modulen wurde als erhöht eingeschätzt – insbesondere für das Fach Psychiatrie (> 5 von 10). Am belastendsten wurde der Unterricht am Krankenbett, gefolgt von Seminaren und Vorlesungen eingeschätzt (alle Paarvergleiche p 5 out of 10). Bedside teaching was estimated as being the most stressful, followed by seminars and lectures (all pairwise comparisons p 5 von 10). Am belastendsten wurde der Unterricht am Krankenbett, gefolgt von Seminaren und Vorlesungen eingeschätzt (alle Paarvergleiche p 5 out of 10). Bedside teaching was estimated as being the most stressful, followed by seminars and lectures (all pairwise comparisons p < 0.001). The contents on depression predominantly caused the most stress. Approximately half of the students would like to be offered support services and most frequently a consultation session (78.0%) and defined contact persons (70.7%). Conclusion The emotional stress of students in the context of teaching on mental disorders is particularly high in psychiatry and higher with increasing patient contact; offers of support services are needed. Teachers should be sensitized to this and create offers such as open consultation sessions and the provision of defined contact persons
A Systematic Review
No full textAbstract Patients with schizophrenia are the largest population in forensic hospitals, and treatment-resistant psychosis is associated with length of stay. For patients with severe and treatment-resistant psychotic disorders, electroconvulsive therapy (ECT) is a potentially effective treatment. Data regarding the use of ECT in forensic psychiatry are scarce. This systematic review aims to provide an overview of the use of ECT in forensic psychiatry. Three databases (PubMed, Web of Science, and PsycINFO) were searched for publications since 1980. Peer-reviewed articles describing patients who underwent ECT treatment in the context of forensic psychiatry were included when a treatment outcome was reported. We identified 5 case reports and 1 case series comprising 13 patients treated with ECT in forensic settings. The quality of evidence was poor accompanied by a considerable risk of bias. Patients were diagnosed with schizophrenia spectrum disorders (n = 10) or depression with psychotic features (n = 3). Eleven patients (84.6%) were described as responders in terms of symptom improvement associated with a reduction of aggressive behavior and improved functioning. At least 3 patients were able to return to community settings. Despite the very limited evidence base, our review suggests that patients in forensic hospitals may benefit from ECT, but more systematic and higher-quality evidence is urgently needed. In addition to prospective, controlled observational studies, a qualitative view focusing on patients' perspectives in this specific setting is of particular importance
Electroconvulsive therapy: what should be done when the needs exceed the treatment capacities?—A medical ethics guidance
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Effectiveness of maintenance electroconvulsive therapy—Evidence from modifications due to the COVID‐19 pandemic
No full textOverlooking the obvious? Influence of electrolyte concentrations on seizure quality parameters in electroconvulsive therapy
No full textOne year of digital teaching in psychiatry as a response to the COVID-19 pandemic: Knowledge gain and content evaluation of medical students for two summer semesters in 2020 and 2021
No full textAfter the beginning of the COVID-19 pandemic in 2020, digital teaching had to be implemented by most universities at short notice and widely replaced classroom teaching. As a consequence, digital teaching further reduced direct social interaction for students. One year after the introduction of digital teaching formats at our university medical center (department of psychiatry and psychotherapy), teaching evaluation of students from summer semesters 2020 and 2021 (SS20, SS21) were compared. The main objective of this study was to objectify whether students evaluate digital teaching less favorably after one year of its implementation. Ratings of 311 medical students on (1) knowledge gain, (2) teaching contents and (3) subjective advantages of digital teaching were analyzed for the two separate cohorts SS20 (n = 175) and SS21 (n = 136). Students also rated their pandemic-related stress level, and if learning progress had been reduced by the pandemic in general. Significant knowledge gain was achieved for all included domains in psychiatry (all p < .001), and did not differ between SS20/SS21. Teaching contents in SS21 were rated worse in six out of eight domains compared to SS20 (p < .001 to .05). Also, subjective advantages of digital teaching vanished in most domains comparing the cohorts of SS21 and SS20 (p < .001 to .05). No differences were found for pandemic-related stress level and subjective learning progress. Limitations include the post-hoc design, possible bias from individual exam grades, and sampling bias. The present study showed that knowledge gain can be considered to be stable one year after the pandemic-related implementation of digital teaching. However, sustainability of this teaching format should be monitored critically: The subject of psychiatry and psychotherapy thrives on direct communication, which can be compromised when using digital formats only. In this light, implementation of more interactive formats in digital teaching is discussed
Response to electroconvulsive therapy is associated with a more diverse oral microbiome– a prospective longitudinal cohort pilot study
No full textAbstract Recently it has been shown that psychiatric disorders are associated with changes in the host microbiome. Little is known about the association of electroconvulsive therapy (ECT) and microbiome alterations. In our pilot-study, 15 patients with severe or treatment resistant depression were prospectively recruited and oral swabs were collected pre- and post-ECT. Compared to a control group, ECT did not lead to a significant microbial shift in longitudinal samples ( p = 0.65). However, alpha diversity measurements significantly differed between responders and non-responders before ECT (observed species p = 0.014, Shannon p = 0.03) and after ECT (observed species p = 0.015, Shannon p = 0.13)
P.239 Electroconvulsive therapy and the brain: no increase of neurofilament light chain in the treatment course
No full textInfluence of depressed patients' expectations prior to electroconvulsive therapy on its effectiveness and tolerability (Exp-ECT): a prospective study
No full textElectroconvulsive therapy (ECT) is the most effective therapy for severe depressive disorders. Though there are known clinical predictors of response (e.g., higher age, presence of psychotic symptoms), there is a lack of knowledge concerning the impact of patients' expectations on treatment outcome and tolerability in terms of possible placebo/nocebo effects. In 31 patients with unipolar or bipolar depressive disorder, we used a questionnaire to investigate the patients' expectations of ECT effectiveness and tolerability prior to and in the course of the treatment. Additionally, the questionnaire was used after the ECT course for a final assessment. Depressive symptoms and putative side-effects were measured at each time point. General linear models were used to analyze the course of depressive symptoms and patients' expectation of ECT effectiveness and tolerability. ECT significantly reduced depressive symptoms with large effect sizes. Patients' rating of ECT effectiveness decreased in parallel: While responders' rating of ECT effectiveness remained stable on a high level, non-responders' rating decreased significantly. Group difference was significant after, but not prior to and during the treatment. Regarding tolerability, there was a (temporary) significant increase in the severity of self-rated symptoms such as headache and memory impairment. In contrast, patients' expectation and assessment of ECT tolerability remained unchanged, and their expectations prior to ECT had no impact on the occurrence of side-effects. These findings contradict the presence of relevant placebo/nocebo effects in the context of ECT when investigating a population of mostly chronic or treatment resistant patients with moderate to severe depressive disorder
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