[Coercive measures in German hospitals for psychiatry and psychotherapy : A pilot study by the DGPPN to evaluate a uniform assessment instrument]. / Zwangsmaßnahmen in deutschen Kliniken für Psychiatrie und Psychotherapie : Eine Pilotstudie der DGPPN zur Erprobung eines einheitlichen Erfassungsinstrumentes.

STUDY OBJECTIVE: A simple instrument to record case-related coercive measures was tested as part of a pilot project of the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN). METHODS: To assess coercive measures data were collected for 3 months in 8 German hospitals for psychiatry and psychotherapy. The type of measures used, the main diagnosis and the legal basis for the coercive measures were documented. RESULTS: In the sample studied, coercive measures were applied in 8% of cases. Coercive measures were most commonly used in patients with a schizophrenic disorder. The principle of justifiable necessity according to § 34 of the German Penal Code was used particularly often as the legal basis for justifying the coercive measures. CONCLUSION: Suitable measurement instruments and reliable data that enable the learning of best practices represent the basis for a reduction of coercive measures.

[Restless legs syndrome in patients on dialysis for kidney insufficiency: effect of medication]. / Restless-Legs-Syndrom bei dialysepflichtiger Niereninsuffizienz: Einfluss der Medikation.

BACKGROUND AND OBJECTIVES: Many patients on dialysis have a restless legs syndrome (RLS). Drugs may cause as well as relieve RLS symptoms. It was the aim of this study to examine the effect of the prescribed drugs on the occurrence of RLS in patients on hemodialysis. PATIENTS AND METHODS: The cohort consisted of 82 out-patients undergoing dialysis (38 men and 44 women; mean age 65,4 [21 - 93] years) during 2002 and 2003. In addition to blood analysis the criteria of RLS were analysed, using the Johns Hopkins restless legs severity scale (JHRLSS) and the diagnostic criteria of the International Restless Legs Syndrome Study Group (IRLSSG). Periodic limb movements in sleep (PLMS) were measures by a special device. RESULTS: 25 of 82 patients had RLS symptoms, using the JHRLSS, in 23 this was confirmed by the IRLSSG criteria. PLMS occurred in 46 of 81 patients. The occurrence of RLS correlated significantly with the intake of drugs that could potentially increase RLS severity. But there was no strong correlation with drugs that could potentially decrease it. There was no association between medication and the occurrence of PLMS. There was also no correlation with laboratory parameters. CONCLUSION: In patients on dialysis those drugs which can potentially worsen RLS should be prescribed with care.

[Psychosis-induced posttraumatic stress disorder. A rarely diagnosed symptom]. / Die psychoseinduzierte posttraumatische Belastungsstörung. Ein selten diagnostiziertes Krankheitsbild.

Patients with severe mental disorders encounter a rather high risk of also evolving symptoms of posttraumatic stress disorder (PTSD) as a result of psychotic experience. A wide overlap of symptoms makes the differentiation between "psychosis-induced PTSD" and "psychotic warning signs" difficult; nevertheless, the distinction is important as different therapy strategies must be envisaged. A case report of a psychosis-induced PTSD is given.