[The situation in the German forensic commitment-Results of a survey by the DGPPN]. / Die Situation des deutschen Maßregelvollzugs ­ Ergebnisse einer Umfrage der DGPPN.

BACKGROUND AND OBJECTIVE: In German forensic psychiatry detention under Sections 63 and 64 of the German Penal Code have been repeatedly reformed over the past years; however, despite the most recent amendments to the law on detention, clinics and state authorities warn of insufficient capacities and worrying conditions. Media reports paint a defiant picture. At the same time, there is a lack of valid data that would allow an objective description of the situation in forensic psychiatry. Against this background the management of institutions in Germany has been surveyed. MATERIAL AND METHODS: The survey was conducted as an online survey and sent to all 78 forensic hospitals in Germany. The survey covered topics such as structural data of the facilities, the occupancy and staffing situation, incidents, support from supervisory authorities and funding agencies, and patient characteristics. The results are presented descriptively. RESULTS: Of the 78 facilities contacted, 45 (approximately 60%) participated at least partially in the survey. Many of the clinics (68.5%) complained of significant overcrowding. A clear lack of staff and rooms was reported, at the same time it was stated that patients do not receive adequate treatment. Approximately 1 in 5 patients have a length of stay for more than 10 years and one third of the clinics reported an increasing number of physical assaults by patients. CONCLUSION: This overview shows that the forensic psychiatric hospitals are in very different but generally strained situations. A significant number of clinics are under great pressure. Financial, structural, spatial and personnel resources were described as insufficient to properly and professionally fulfill the legal mandate. The treatment standards presented by the DGPPN in 2017 are not met in many clinics.

[Course of anxiety, depression, and quality of life in relatives of patients with Creutzfeldt-Jakob-Disease] / Verlauf von Angst, Depressivität und Lebensqualität bei Angehörigen von Creutzfeldt-Jakob-Kranken (CJK).

Creutzfeldt-Jakob-Disease (CJD) is a rapidly progressing fatal disease. Most patients will not know the diagnosis, they leave reality in an early stage and go into dementia. The most afflicted persons are their relatives. They are forced to observe the patients' physical and mental decline. In this survey we included all cases of CJD who were registered in Germany within seven months. Questionnaires were sent to the closest relatives (n = 58). The response rate (n = 42) was acceptable. There was a high prevalence of abnormal anxiety and depression scores and bad quality of life. One fourth (n = 10) took part in a self-help meeting in Göttingen. Six months later, a follow-up assessment showed that relatives, who had participated in the self-help meeting, had significantly (p < 0,05) improved quality of life although their high levels of anxiety and depression persisted. The non-participants had no changes of depression or quality of life, but slightly improved anxiety. The severe psychological burden of these relatives could be a reaction to the physical and mental fall of the CJD-patient. It is higher that that of relatives of patients with different diseases in the literature. Special support for this group of relatives seems necessary.