[Actual care and funding situation with regard to mother-child units for psychic disorders associated with pregnancy in Germany]. / Aktuelle Versorgungs- und Finanzierungslage von Mutter-Kind-Einheiten für schwangerschaftsassoziierte psychische Störungen in Deutschland.

UNLABELLED: CONCERN: The current care and financial situation of mother-child units for psychic disorders associated with pregnancies in Germany should be documented in preparation for the development of the new reimbursement system for psychiatry and psychosomatics. METHOD: In accordance with the last survey of 2005, a brief questionnaire was developed and a nationwide poll was conducted. RESULTS: The survey revealed severe (10 fold) service deficits for severely and gravely mentally ill mothers, who require an inpatient treatment with specific professional competence. Compared with the last poll, these service deficits have increased. This is due to continued insufficient funding and unresolved financing in the new reimbursement system. With the establishment of an additional code for mother-child treatment the precondition for ensuring the funding of this important care form in the new reimbursement system was created. CONCLUSION: It is to be hoped that the decision-makers of health policy will finally face up to their social responsibility and ensure adequate funding of the additional diagnostic and therapeutic expenditure of mother-child treatment. The health care providers have an obligation to implement a transparent record of services of the additional expenditure and to augment the national evaluation approaches to inpatient mother-child treatments.

[Perinatal prevention network for mentally burdened and adolescent mothers]. / Perinatales Präventionsnetz für psychisch belastete und jugendliche Mütter.

Psychiatric disorder in pregnancy and after child birth as well as psychological distress are well known factors that put child wellbeing at risk. They are, however, often estimated as less frequent and less severe then they occur. Postpartum psychiatric disorder meets mothers of all social classes, they are highly stigmatized, therefore often disregarded and remain undetected. The affected mothers socially withdraw themselves due to feelings of shame, fear and guilt. They cut themselves off from psychiatric treatment and from support by child welfare institutions. The regional network "Hand in Hand" in the Rhine-Neckar-area consisting of psychiatrists, psychotherapists, gynaecologists, paediatricians, social workers and midwives uses and connects the resources available in public health and youth aid to support both the child wellbeing as well as the mental health of mothers. Our program begins by identifying risk factors for mothers' postpartum disorders and continues by increasing awareness with the previous named professional groups, so that they act promptly and offer treatment and support. The following paper describes our network activities emphasizing anti-stigma, instruction of professionals and intervention with affected families.

Do sex differences affect prefrontal cortex associated cognition in schizophrenia?

UNLABELLED: Cognitive deficits in schizophrenia, especially those related to prefrontal cortex (PFC) functions, influence functional outcome. There is evidence for sex differences in cognition in schizophrenia, but the results in the literature are still controversial. OBJECTIVE: This study evaluated different modalities of working memory (WM) and executive control (EC), functions that are both associated with the PFC, between sexes in schizophrenic patients and controls. METHODS: We used a battery of neuropsychological tests for assessing auditory, spatial, and visual-matching WM and used a dual task for assessing EC. The study included 50 inpatients (25 female) partially remitted and taking atypical neuroleptics, as well as 40 controls (20 female) matched for age and education. RESULTS: Significant sex differences were found in the dual task; female patients detected fewer correct trials than male patients and controls did. Moreover, female patients performed significantly worse in the single visual subtest of the dual task. For the controls, no sex differences were found. Males showed higher positive symptoms than females, but no other differences in psychopathology, disease characteristics, or extrapyramidal symptoms were found between sexes. CONCLUSION: The present study shows an absence of sex differences in WM in healthy subjects and in patients with schizophrenia. However, in the dual task and in the single visual subtest, female patients performed worse than males. This finding suggests that in contrast to males, nonacute female inpatients show an underlying attentional deficit that may contribute to impairment in higher-order functions such as EC.