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Cellulose acetate (CA), a prominent water-soluble derivative of cellulose, is a promising biodegradable ingredient that has applications in films, membranes, fibers, drug delivery, and more. In this work, we present a molecularly informed field-theoretic model for CA to explore its phase behavior in aqueous solutions. By integrating atomistic details into large-scale field-theoretic simulations via the relative entropy coarse-graining framework, our approach enables efficient calculations of CA's miscibility window as a function of the degree of substitution (DS) of cellulose hydroxyl groups with acetate side chains. This allows us to capture the intricate phase behavior of CA, particularly its unique miscibility at intermediate substitution, without relying on experimental input. Additionally, the model directly probes CA solution behavior specific to the relative DS at C2, C3, and C6 alcohol sites, providing insights for the rational design of water-soluble CA for diverse applications. This work demonstrates a promising integration of molecularly informed field theories, complementing wet-lab experimentation, for engineering the next-generation polymeric materials with precisely tailored properties.
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PURPOSE: Depressive disorders cause a major burden of disease worldwide and often lead to a loss of social functioning. Patients suffering from depressive disorders report a lower quality of life (QOL) than people without a history of mental health issues. Internet-based interventions (IBIs) based on cognitive behavioral therapy (CBT) are effective in reducing symptom severity but data on their impact on quality of life in clinically depressed patients so far is scarce. METHODS: Selfapy is a CBT-based IBI for depressive disorders. 401 participants (332 female, mean age 37 (SD = 11) with a diagnosis of major depressive disorder (MDD) or dysthymia were enrolled in a randomized, parallel, three-arm trial comparing a therapist-guided Selfapy intervention with an unguided Selfapy intervention and a waiting list control. QOL was measured using the WHOQOL-BREF at baseline, post-treatment (12 weeks) and at 24-week follow-up. The effects of the interventions on QOL were calculated using linear mixed effects models. RESULTS: At post-treatment (12 weeks) the guided and unguided intervention groups reported an increase in QOL on physical and psychological health domains compared to controls (significant group*time interaction). The gain in QOL was maintained over the follow-up period only for psychological health. QOL decreased in the social relationships and environment domains over the course of treatment and during the follow-up treatment for all participants. There were no differences between the guided and the unguided intervention. CONCLUSION: Selfapy proved to positively affect psychological and physical QOL in a sample of participants suffering from depressive disorders and can therefore be considered an effective and highly scalable therapeutic tool. The pattern of results might partly be attributable to effects of the COVID-19 pandemic and public health measures that coincided with the trial. TRIAL REGISTRATION: German Clinical Trials Register (DRKS): DRKS00017191. Registered June 14th, 2019, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017191 .
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Terapia Cognitivo-Conductual , Intervención basada en la Internet , Calidad de Vida , Humanos , Femenino , Calidad de Vida/psicología , Masculino , Adulto , Terapia Cognitivo-Conductual/métodos , Persona de Mediana Edad , Trastorno Depresivo Mayor/terapia , Trastorno Depresivo Mayor/psicología , Internet , Resultado del Tratamiento , Autocuidado/psicologíaRESUMEN
BACKGROUND: Internet-based interventions (IBIs) for the treatment of depression have been found to have positive effects in international meta-analyses; however, it is unclear whether these effects also extend to IBIs specifically available in Germany. The aim of this meta-analysis was to estimate the immediate effects and the long-term effects of IBIs available in Germany free of charge or available on prescription and covered by the public health insurances as so-called digital health applications (DiGAs) and to compare the efficacy of DiGAs and freely available IBIs. METHOD: A systematic literature search and random-effects meta-analysis were performed (preregistration: INPLASY202250070). Randomized controlled trials (RCTs) of IBIs freely available in Germany or as DiGA in adults with elevated depressive symptoms were compared with active and inactive controls available at the time of the survey in May 2022. RESULTS: A total of six interventions were identified: COGITO, deprexis, iFightDepression, moodgym, Novego, and Selfapy. The pooled effect size of a total of 28 studies with 13,413 participants corresponded to an effect of Cohen's dâ¯= 0.42, (95% confidence interval, CI: 0.31-0.54, I2â¯= 81%). The analysis of long-term effects showed a smaller effect size of dâ¯= 0.29, (95% CI: 0.21-0.37, I2â¯= 22%, Nâ¯= 10). Subgroup analyses indicated a possible superiority of the three interventions listed in the DiGA directory (dâ¯= 0.56, 95% CI: 0.38-0.74, I2â¯= 83%, Nâ¯= 15) compared to the three freely available IBIs (dâ¯= 0.24, 95% CI: 0.14-0.33, I2â¯= 44%, Nâ¯= 13, pâ¯= 0.002). CONCLUSION: The IBIs for depressive disorders available in Germany are effective and can therefore be used in the treatment of people with a depressive disorder; however, it is possible that not all interventions are equally effective.
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Depresión , Intervención basada en la Internet , Humanos , Depresión/diagnóstico , Depresión/terapia , AlemaniaRESUMEN
Bacteria of the genus Brucella are facultative intracellular parasites that cause brucellosis, a severe animal and human disease. Recently, a group of taxonomists merged the brucellae with the primarily free-living, phylogenetically related Ochrobactrum spp. in the genus Brucella. This change, founded only on global genomic analysis and the fortuitous isolation of some opportunistic Ochrobactrum spp. from medically compromised patients, has been automatically included in culture collections and databases. We argue that clinical and environmental microbiologists should not accept this nomenclature, and we advise against its use because (i) it was presented without in-depth phylogenetic analyses and did not consider alternative taxonomic solutions; (ii) it was launched without the input of experts in brucellosis or Ochrobactrum; (iii) it applies a non-consensus genus concept that disregards taxonomically relevant differences in structure, physiology, population structure, core-pangenome assemblies, genome structure, genomic traits, clinical features, treatment, prevention, diagnosis, genus description rules, and, above all, pathogenicity; and (iv) placing these two bacterial groups in the same genus creates risks for veterinarians, medical doctors, clinical laboratories, health authorities, and legislators who deal with brucellosis, a disease that is particularly relevant in low- and middle-income countries. Based on all this information, we urge microbiologists, bacterial collections, genomic databases, journals, and public health boards to keep the Brucella and Ochrobactrum genera separate to avoid further bewilderment and harm.
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Brucella , Ochrobactrum , Ochrobactrum/clasificación , Ochrobactrum/genética , Ochrobactrum/patogenicidad , Ochrobactrum/fisiología , Brucella/clasificación , Brucella/genética , Brucella/patogenicidad , Brucella/fisiología , Terminología como Asunto , Filogenia , Brucelosis/tratamiento farmacológico , Brucelosis/microbiología , Humanos , Infecciones Oportunistas/microbiologíaRESUMEN
Tree growth in boreal forests is driven by ectomycorrhizal fungal mobilisation of organic nitrogen and mineral nutrients in soils with discrete organic and mineral horizons. However, there are no studies of how ectomycorrhizal mineral weathering and organic nitrogen mobilisation processes are integrated across the soil profile. We studied effects of organic matter (OM) availability on ectomycorrhizal functioning by altering the proportions of natural organic and mineral soil in reconstructed podzol profiles containing Pinus sylvestris plants, using 13 CO2 pulse labelling, patterns of naturally occurring stable isotopes (26 Mg and 15 N) and high-throughput DNA sequencing of fungal amplicons. Reduction in OM resulted in nitrogen limitation of plant growth and decreased allocation of photosynthetically derived carbon and mycelial growth in mineral horizons. Fractionation patterns of 26 Mg indicated that magnesium mobilisation and uptake occurred primarily in the deeper mineral horizon and was driven by carbon allocation to ectomycorrhizal mycelium. In this horizon, relative abundance of ectomycorrhizal fungi, carbon allocation and base cation mobilisation all increased with increased OM availability. Allocation of carbon through ectomycorrhizal fungi integrates organic nitrogen mobilisation and mineral weathering across soil horizons, improving the efficiency of plant nutrient acquisition. Our findings have fundamental implications for sustainable forest management and belowground carbon sequestration.
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INTRODUCTION: Lithium augmentation (LA) of antidepressants is a first-line therapy option for treatment-resistant depression (TRD). Nevertheless, it is rarely used in geriatric patients mostly because of the fear of kidney toxicity. The purpose of this study is to investigate estimated glomerular filtration rate (eGFR) changes and number of acute kidney injuries (AKI) using LA in geriatric compared with non-geriatric patients. METHODS: In a prospective multicenter cohort study, eGFR changes were measured in 201 patients with unipolar depression (nage≥65years = 29; nage<65years = 172) at baseline and over 2-6 weeks of LA. We used linear mixed models to investigate changes in eGFR upon LA and assessed the number of AKIs, according to the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines. RESULTS: Both age groups showed a significant eGFR decline over the course of treatment with lower eGFR in geriatric patients. The lithium serum level (interpretable as "effect of LA") had a significant effect on eGFR decline. Both effects (age group and lithium serum level) on eGFR decline did not influence each other, meaning the effect of LA on eGFR decline did not differ between age groups. Two AKIs were observed in the geriatric age group when serum lithium levels exceeded the therapeutic range of >0.8 mmol/L. CONCLUSION: This is the first study investigating eGFR change and AKI upon LA for TRD in geriatric compared with non-geriatric patients. Our data suggest that LA, as an effective treatment option in geriatric patients, should be closely monitored to avoid AKIs.
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Lesión Renal Aguda , Trastorno Depresivo Resistente al Tratamiento , Humanos , Anciano , Litio/uso terapéutico , Depresión , Estudios de Cohortes , Estudios Prospectivos , Riñón , Trastorno Depresivo Resistente al Tratamiento/tratamiento farmacológico , Lesión Renal Aguda/inducido químicamente , Lesión Renal Aguda/tratamiento farmacológicoRESUMEN
The self-assembly and phase separation of mixtures of polyelectrolytes and surfactants are important to a range of applications, from formulating personal care products to drug encapsulation. In contrast to systems of oppositely charged polyelectrolytes, in polyelectrolyte-surfactant systems the surfactants micellize into structures that are highly responsive to solution conditions. In this work, we examine how the morphology of micelles and degree of polyelectrolyte adsorption dynamically change upon varying the mixing ratio of charged and neutral surfactants. Specifically, we consider a solution of the cationic polyelectrolyte polydiallyldimethylammonium, anionic surfactant sodium dodecyl sulfate, neutral ethoxylated surfactants (C[Formula: see text]EO[Formula: see text]), sodium chloride salt, and water. To capture the chemical specificity of these species, we leverage recent developments in constructing molecularly informed field theories via coarse-graining from all-atom simulations. Our results show how changing the surfactant mixing ratios and the identity of the nonionic surfactant modulates micelle size and surface charge, and as a result dictates the degree of polyelectrolyte adsorption. These results are in semi-quantitative agreement with experimental observations on the same system.
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The critical micelle concentration (CMC) is a crucial parameter in understanding the self-assembly behavior of surfactants. In this study, we combine simulation and experiment to demonstrate the predictive capability of molecularly informed field theories in estimating the CMC of biologically based protein surfactants. Our simulation approach combines the relative entropy coarse-graining of small-scale atomistic simulations with large-scale field-theoretic simulations, allowing us to efficiently compute the free energy of micelle formation necessary for the CMC calculation while preserving chemistry-specific information about the underlying surfactant building blocks. We apply this methodology to a unique intrinsically disordered protein platform capable of a wide variety of tailored sequences that enable tunable micelle self-assembly. The computational predictions of the CMC closely match experimental measurements, demonstrating the potential of molecularly informed field theories as a valuable tool to investigate self-assembly in bio-based macromolecules systematically.
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Proteínas Intrínsecamente Desordenadas , Micelas , Tensoactivos , Simulación por ComputadorRESUMEN
To better predict the timely variation of algal blooms and other vital factors for safer drinking water production, a new AI scanning-focusing process was investigated for improving the simulation and prediction of algae counts. With a feedforward neural network (FNN) as a base, nerve cell numbers in the hidden layer and the permutation and combination of factors, etc., were fully scanned to select the best models and highly correlated factors. All the factors involved in the modeling and selection included the date (year/month/day), sensor data (temperature, pH, conductivity, turbidity, UV254-dissolved organic matter, etc.), lab measurements (algae concentration) and calculated CO2 concentration. The new AI scanning-focusing process resulted in the best models with the most suitable key factors, which are named closed systems. In this case study, models with highest prediction performance are the (1) date-algae-temperature-pH (DATH) and (2) date-algae-temperature-CO2 (DATC) systems. After the model selection process, the best models from both DATH and DATC were used to compare the other two methods in the modeling simulation process: the simple traditional neural network method (SP), where only date and target factor as inputs, and a blind AI training process (BP), which considers all available factors as inputs. Validation results show that all methods except BP had comparable results for algae prediction and other water quality factors, such as temperature, pH and CO2, among which DATC displayed an obviously poorer performance through curve fitting with original CO2 data compared to that of SP. Therefore, DATH and SP were selected for the application test, where DATH outperformed SP due to the uncompromised performance after a long training period. Our AI scanning-focusing process and model selection showed the potential for improving water quality prediction by identifying the most suitable factors. This provides a new method to be considered in the enhancing of numerical prediction for the factors in water quality prediction and broader environment-related areas.
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Agua Potable , Dióxido de Carbono , Calidad del Agua , Eutrofización , Redes Neurales de la ComputaciónRESUMEN
INTRODUCTION: Emotion regulation (ER), the ability to actively modulate one's own emotion reactions, likely depends on the individual's current emotional state. Here, we investigated whether negative emotions induced by an interpersonal autobiographic script affect the neuronal processes underlying ER. METHODS: Twenty healthy participants were recruited and underwent functional magnetic resonance imaging (fMRI) during performance of distancing, a specific ER strategy, while viewing emotionally arousing pictures. Participants were instructed to either naturally experience ("permit" condition) or to actively downregulate ("regulate" condition) their emotional responses to the presented stimuli. Before each of the 4 runs in total, a neutral or negative autobiographical audio script was presented. The negative script comprised an emotionally negative event from childhood or adolescence that represented either emotional abuse or emotional neglect. The second event comprised an everyday neutral situation. We aimed at identifying the neural correlates of ER and their modulation by script-driven imagery. RESULTS: fMRI analyses testing for greater responses in the "regulate" than the "permit" condition replicated previously reported neural correlates of ER in the right dorsolateral prefrontal cortex and the right inferior parietal lobule. A significant ER effect was also observed in the left orbitofrontal cortex. In the amygdala, we found greater responses in the "permit" compared to the "regulate" condition. We did not observe a significant modulation of the ER effects in any of these regions by the negative emotional state induced by autobiographical scripts. Bayesian statistics confirmed the absence of such modulations by providing marginal evidence for null effects. DISCUSSION: While we replicated previously reported neural correlates of ER, we found no evidence for an effect of mood induction with individualized autobiographical scripts on the neural processes underlying ER in healthy participants.
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Regulación Emocional , Adolescente , Amígdala del Cerebelo , Teorema de Bayes , Encéfalo , Mapeo Encefálico , Niño , Emociones/fisiología , Humanos , Imagen por Resonancia MagnéticaRESUMEN
The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) was originally developed for outpatients with persistent depressive disorder (PDD). We adapted CBASP as inpatient treatment on a general acute psychiatric ward and evaluated its outcome and feasibility. Sixty PDD patients received a 12-week multidisciplinary CBASP program. Hamilton Depression Rating Scale (HAMD24) and Beck Depression Inventory (BDI-II) served as primary and secondary outcome measures. Childhood maltreatment at baseline and change in interpersonal distress from pre to post were investigated as predictors of treatment outcome. A 6-month follow-up assessment was conducted. Feasibility was assessed through dropouts and satisfaction with the program. Fifty patients completed the program (16.7% dropouts). An ANOVA with three repeated measurements (pre, post, FU) in the ITT sample revealed a main effect of time. For the primary outcome, depressive symptoms decreased from pre (28.3) to post (11.5, response rate: 72.7%, d = 1.8), and from pre to FU (13.9, d = 1.2). Four patients relapsed. The secondary outcome confirmed the results; however, the response rate was lower (BDI-II: 31.7%, pre to post: d = 0.8, pre to FU: d = 0.3), and ten patients relapsed at FU. Reduction in interpersonal distress, but not childhood maltreatment, predicted BDI-II response. Key limitations of this naturalistic open trial are the lack of a comparison group and non-blinded HAMD24 ratings. Inpatient CBASP for PDD appears feasible on a general acute psychiatric ward with effect sizes comparable to specialized psychotherapy wards and to the outpatient setting.
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Antidepresivos/administración & dosificación , Terapia Cognitivo-Conductual , Trastorno Depresivo Resistente al Tratamiento/terapia , Evaluación de Resultado en la Atención de Salud , Enfermedad Aguda , Adulto , Anciano , Terapia Combinada , Estudios de Factibilidad , Femenino , Estudios de Seguimiento , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Servicio de Psiquiatría en Hospital , Adulto JovenRESUMEN
OBJECTIVES: Drug checking as a tool for harm reduction is offered in certain cities throughout Europe, the USA, and Australia, but in general, it is internationally still scarcely available and controversially discussed. This study aimed at investigating the potential impact of a drug-checking offer on Berlin nightlife attendees' illicit drug use and at identifying the encouraging and discouraging factors for using or refraining from such an offer. METHODS: Using an online questionnaire, we conducted a cross-sectional survey in a Berlin party scene. A total of 719 people participated in the survey that took part in 2019. RESULTS: The vast majority of participants (92%) stated that they would use drug checking, if existent. If the test revealed the sample to contain a high amount of active ingredient, 91% indicated to take less of the substance than usual. Two-thirds (66%) would discharge the sample if it contained an unexpected/unwanted agent along with the intended substance. If the sample contained only unexpected/unwanted substances and not the intended substance at all, 93% stated to discharge the sample. Additional brief counseling was stated to be useful. Participants showed a comparatively high substance use. CONCLUSIONS: Drug checking as a harm reduction tool was highly accepted in the scene, and the majority of participants stated to align their consumption behavior accordingly, in a reasonable manner. A concomitant consultation would be appreciated, which may be used to direct educational information about harms and risks to users.
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Trastornos Relacionados con Sustancias , Berlin , Estudios Transversales , Femenino , Humanos , Drogas Ilícitas , MasculinoRESUMEN
BACKGROUND: Although the individual and economic disease burden of depression is particularly high for long-term symptoms, little is known of the lifetime course of chronic depression. Most evidence derives from clinical samples, and the diagnostic distinction between persistent depressive disorder (PDD) and non-chronic major depression (NCMDD) is still debated. Thus, we examined characteristics of PDD among clinical vs. non-clinical cases, and the associated disease burden at a population level. METHODS: Data were drawn from the mental health module of the German Health Interview and Examination Survey for Adults (DEGS1-MH, 2009-2012, n = 4483) and a clinical sample of PDD inpatients at Charité - Universitätsmedizin Berlin (2018-2019, n = 45). The DSM-5 definition of PDD was operationalized a priori to the study using interview-based DSM-IV diagnoses of dysthymia and major depression lasting at least 2 years in both surveys. Additional depression characteristics (depression onset, self-classified course, suicidality, comorbid mental disorders, treatment history and current depressive symptoms [Patient Health Questionnaire-9]) were assessed. In the DEGS1-MH, health-related quality of life (Short Form Health Survey-36, SF-36), chronic somatic conditions, number of sick days (past 12 months) or days with limitations in normal daily life activities (past 4 weeks), and health service utilization (past 12 months) were compared for PDD vs. NCMDD. RESULTS: PDD cases from the clinical sample had a significantly earlier depression onset, a higher proportion of self-classification as persistent course, and treatment resistance than PDD and NCMDD cases in DEGS1-MH. At a population level, PDD cases showed worse outcomes compared with NCMDD cases in terms of somatic comorbidity, SF-36 mental component score, and activity limitations owing to mental health problems, as well as a higher risk for outpatient mental health care contact. CONCLUSIONS: The distinction between PDD and NCMDD proposed for DSM-5 seems warranted. Early onset depression, self-classification as persistent depressive course, and treatment resistance are suggested as markers of more severe and chronic depression courses. At a population level, PDD is associated with remarkably higher individual and economic disease burden than NCMDD, highlighting the need to improve medical recognition of chronic courses and establish specific treatment concepts for chronic depression.
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Envejecimiento/psicología , Trastorno Depresivo/epidemiología , Encuestas Epidemiológicas , Adolescente , Adulto , Anciano , Comorbilidad , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Calidad de Vida , Adulto JovenRESUMEN
Achieving thermodynamic faithfulness and transferability across state points is an outstanding challenge in the bottom-up coarse graining of molecular models, with many efforts focusing on augmenting the form of coarse-grained interaction potentials to improve transferability. Here, we revisit the critical role of the simulation ensemble and the possibility that even simple models can be made more predictive through a smarter choice of ensemble. We highlight the efficacy of coarse graining from ensembles where variables conjugate to the thermodynamic quantities of interest are forced to respond to applied perturbations. For example, to learn activity coefficients, it is natural to coarse grain from ensembles with spatially varying external potentials applied to one species to force local composition variations and fluctuations. We apply this strategy to coarse grain both an atomistic model of water and methanol and a binary mixture of spheres interacting via Gaussian repulsions and demonstrate near-quantitative capture of activity coefficients across the whole composition range. Furthermore, the approach is able to do so without explicitly measuring and targeting activity coefficients during the coarse graining process; activity coefficients are only computed after-the-fact to assess accuracy. We hypothesize that ensembles with applied thermodynamic potentials are more "thermodynamically informative." We quantify this notion of informativeness using the Fisher information metric, which enables the systematic design of optimal bias potentials that promote the learning of thermodynamically faithful models. The Fisher information is related to variances of structural variables, highlighting the physical basis underlying the Fisher information's utility in improving coarse-grained models.
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Patients with severe mental illnesses who are unable to give consent often need a rapid diagnosis and treatment but due to the psychiatric symptoms they often reject such measures. In the routine practice, the question arises to what extent the patient's expressed will should dictate the treatment steps and whether a decision against the patient's will is medically reasonable, ethically justifiable or even demanded and legally permissible. Autoimmune encephalitides, such as Nmethyl-D-aspartate receptor (NMDAR) encephalitis, have recently become important differential diagnoses due to their relative frequency, manifold symptoms and good treatability, as the underlying autoantibodies frequently cause organic psychoses. Using a complex case of a patient with NMDAR encephalitis, which was confirmed in the course of treatment, this article discusses the ethical and legal issues that are relevant in practice, from initial invasive diagnostics to involuntary confinement and compulsory treatment. The article discusses how physicians can respect the autonomy of such patients in the best way and how they can identify and resolve potential contradictions between the free will and the expressed will. Various convictions of physicians about autonomy and coercive treatment are discussed on the basis of the legal situation. Finally, it is discussed how the indications for a short compulsory treatment can be justified before the court of protection on the grounds of an analogy of autoimmune encephalitis to other severe brain diseases.
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Encefalitis , Enfermedad de Hashimoto , Autoanticuerpos , Árboles de Decisión , Encefalitis/diagnóstico , Encefalitis/terapia , Enfermedad de Hashimoto/diagnóstico , Enfermedad de Hashimoto/terapia , Humanos , Consentimiento Informado , Autonomía PersonalRESUMEN
Berlin is internationally known for its intense nightlife associated with high rates of psychoactive substance use. Previous studies conducted in other cities indicated college students as a group at high risk for substance (mis-)use that was associated with individual psychological and cognitive impairments as well as lower academic performance. The aim of this study was to provide detailed data about the substance use patterns of Berlin college students. In addition, major protective and risk factors were analysed. An online questionnaire assessing sociodemographic data and various relevant aspects of both legal and illegal substance use such as consumption pattern and frequency as well as risk-taking behaviour was developed and distributed among colleges in Berlin. A sample of 9351 participants from 17 different colleges in Berlin completed the questionnaire. The study revealed high lifetime (69.3%), past year (45.9%) and past month (28.3%) prevalence of illicit substance use in the sample. Daily tobacco-smoking, a mental disorder diagnosis, a positive screening for problematic consumption (Cage-AID), bisexual orientation and living in open relationship were main factors positively associated with the prevalence and the extent of illicit substance use. Students in Berlin appear to show higher rates of illicit substance use than was previously reported for age-matched individuals in the general German population and college students in other cities. Thus, they are a relevant target group for early prevention and intervention concerning substance use and abuse.
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Consumidores de Drogas/psicología , Psicotrópicos/efectos adversos , Estudiantes/psicología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/psicología , Universidades/tendencias , Adulto , Estudios Transversales , Femenino , Alemania/epidemiología , Humanos , Drogas Ilícitas/efectos adversos , Masculino , Adulto JovenRESUMEN
BACKGROUND: There is still uncertainty if and to what extent chronic depression (CD) presents with specific features especially in contrast to the nonchronic course of major depressive disorder (non-CD). This systematic review aims to summarize the existing literature regarding sociodemographic factors, psychopathology, and course of disease in patients with CD in comparison to patients with non-CD. METHODS: A structured database search (MEDLINE, PsycINFO, Web of Science, CENTRAL) was performed. All studies comparing CD with non-CD patients were included. Twenty-eight studies, including cohort studies, cross-sectional studies, and observational studies, were identified in which both subgroups were diagnosed according to DSM-IV or DSM-5, respectively. Primary outcome were group comparisons focused on sociodemographic factors, childhood adversity, onset of the disorder, comorbidities, severity and course of the depressive symptoms, and specific psychopathology. RESULTS: Patients with CD had an earlier onset of depressive symptoms, higher rates of psychiatric comorbidities, and a complicated treatment course (e.g., higher rates of suicidality) compared to non-CD. We also found some evidence for specific features in the psychopathology of CD patients (submissive and hostile interpersonal styles) in contrast to non-CD patients. Results were inconsistent with regard to childhood maltreatment. No differences were found regarding the severity of depressive symptoms and most sociodemographic factors. CONCLUSION: Despite some inconsistencies, the results of this review verified important differences between CD and non-CD. However, future research is needed to characterize especially the specific psychopathology of CD in comparison to non-CD patients to develop more tailored treatment strategies.
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Depresión/psicología , Depresión/terapia , Trastorno Depresivo Mayor/psicología , Trastorno Depresivo Mayor/terapia , Estudios de Cohortes , Comorbilidad , Estudios Transversales , Depresión/diagnóstico , Trastorno Depresivo Mayor/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , HumanosRESUMEN
BACKGROUND: Berlin is internationally known for its nightlife. In a nation-wide and Europe-wide comparison, the use of legal and illegal substances is comparatively higher in Berlin than in other similar cities. However, few data exist about the drug use in the party scene. OBJECTIVE: This study aims to assess the sociodemographic characteristics of Berlin's party scene and its patterns of substance use as well as expectations towards prevention in order to derive appropriate preventive measures. METHODS: Using questionnaires, both online (n = 674) and in the field (n = 203), a total of 877 people of the Berlin party scene were interviewed. The questionnaires ascertained the demographic information of the participants and patterns of substance use in the scene. It also collected the demand for consulting services and personal assessments on the usefulness of prospective and existing prevention programs and offers. RESULTS: The study participants were 29 years old (SD 7.5); 43% were female. Alcohol is the most common substance in the party scene, followed by cannabis, MDMA/Ecstasy, amphetamine, cocaine, and ketamine. In this particular cohort, methamphetamine and "legal highs" did not play a major role. The most demanded preventive measure was more education about drugs and the so called drug-checking. CONCLUSIONS: Prevention in this area is both needed and requested, and an expansion of the existing programs (e.g., by so far politically controversial drug-checking) should be considered.
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Consumidores de Drogas/psicología , Actividades Recreativas/psicología , Prevención Primaria , Adulto , Berlin , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are common functional gastrointestinal disorders with overlapping symptoms. Effectiveness and safety of Menthacarin (Menthacarin® is the active ingredient of the product Carmenthin® [Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany]) in FD treatment were already demonstrated. We assessed the effectiveness of Menthacarin in reducing concomitant IBS-associated symptoms in FD patients. A systematic search to identify eligible double-blind, randomized controlled trials (RCTs) investigating Menthacarin in FD patients and focusing on IBS-associated symptoms was performed. Three out of five identified RCTs included a total of 111 eligible subjects, which allowed for summary statistics and inclusion into subgroup analysis for FD patients with IBS-associated symptoms. With pain intensity values decreasing by 50-75% on average during 28 days of treatment in patients with accompanying IBS, the subgroup analysis indicates beneficial treatment effects of Menthacarin that are similar to those found for FD patients in the primary analyses. The reduction of IBS-associated symptoms in FD patients suggests Menthacarin as a treatment option for IBS patients.
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Dispepsia , Síndrome del Colon Irritable , Dolor Abdominal , Método Doble Ciego , Dispepsia/epidemiología , Femenino , Alemania , Humanos , Síndrome del Colon Irritable/epidemiología , Masculino , Mentha piperita , Aceites de Plantas/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del TratamientoRESUMEN
Behavioral therapy has greatly evolved and branched out in different directions since its inception. Three stages in the development of modern behavioral psychotherapies can be discerned: behaviorism, the cognitive revolution, and, most recently, the so-called third wave behavioral therapies. Characteristic of third-wave therapies is the great heterogeneity in treatment strategies. To gain a deeper understanding of several third-wave approaches, we here outline relational frame theory (RFT) as an important theoretical foundation. RFT explains how experiential avoidance, a behavioral strategy aimed at eschewing unpleasant internal experiences (e.âg., thoughts, feelings, memories), promotes the onset and progression of psychopathology. Acceptance and commitment therapy (ACT), a prime example of a third-wave therapy, focuses on cultivating the skills needed to embrace discomforting thoughts and emotions. Accumulating evidence including meta-analytic evidence supports the effectiveness of ACT in a wide array of psychiatric disorders.