[Acceptance of psychosocial bridging measures in dementia : Treatment observation during the COVID-19 pandemic]. / Akzeptanz psychosozialer Überbrückungsmaßnahmen im Rahmen demenzieller Erkrankungen : Behandlungsbeobachtung während der COVID-19-Pandemie.

BACKGROUND: In the event of a COVID-19-related absence from an outpatient treatment program, patients suffering from dementia and their caregivers were offered support from a distance. The aim was to examine the extent of the participants' burden as well as how the offer was accepted and evaluated. MATERIAL AND METHODS: All participants (n = 63) were offered supportive telephone contact over a period of 8 weeks at varying frequencies (weekly, fortnightly). In addition patients received cognitive and physical tasks by mail every 2 weeks. In order to examine the acceptance of the support, data collected from clinical routine were included in a treatment observation. Additionally, all participants were asked to evaluate the support retrospectively. RESULTS: Out of 63 contacted participants, 45 were included in the treatment observation. The telephone support was very well accepted and a tendency towards higher agreement could be ascertained by caregivers. The experience of burden remained stable at a moderate level for all participants; however, caregivers were significantly more burdened. CONCLUSION: The present treatment observation shows the acceptance of a location-independent psychosocial treatment program for dementia for future pandemics or treatment failure as well as for the routine care, e.g. for patients with restricted mobility or those living in rural areas without direct hospital connection. In particular, our data strengthen the importance of programs for caregivers in order to alleviate their burden.

Effects of physical activity on cognitive performance: a controlled clinical study in depressive patients.

Physical activity is a common adjunctive therapy in psychiatric and psychosomatic hospitals. In the present study, we assessed the effects of an exercise program, integrated into routine inpatient treatment, on cognitive performance and subjective severity of depression in a sample of patients suffering from major depression. We randomized n = 38 patients with unipolar depression to either physical exercise (n = 18) or occupational therapy as an active control treatment (n = 20). Both treatments were delivered in group format over a period of 3-4 weeks. Data indicate that there were significant improvements of cognitive functions and depressive symptoms in both groups, with specific treatment effects in reaction time and in short-term verbal memory favoring the physical activity group. In conclusion, we found physical exercise to be a feasible, easy-to-implement add-on therapy for depressive patients with promising effects on cognitive performance. However, these results need to be replicated in larger samples with an extended follow-up.

[Neuropsychological treatment of cognitive deficits in substance abuse disorders, affective disorders, anxiety disorders and obsessive-compulsive disorders - current status and perspectives]. / Neuropsychologische Behandlung kognitiver Defizite bei Suchtmittel-, affektiven, Angst- und Zwangserkrankungen - Aktueller Stand und Perspektiven.

Neuropsychological treatment represents a promising therapeutic approach in the amelioration of cognitive deficits in many neuropsychiatric disorders. Cognitive impairment constitutes a core feature that often persists beyond psychopathological symptoms having a significant impact on psychosocial functioning. However, research interest and evidence of efficacy vary considerably between disease groups. Although neuropsychological treatment is frequently used in clinical practice, there are, with the exception of schizophrenia, relatively few studies on its effectiveness.

Driving performance and psychomotor function in depressed patients treated with agomelatine or venlafaxine.

OBJECTIVE: We conducted a randomized case-control study in depressive inpatients to assess the effects of agomelatine and venlafaxine on psychomotor functions related to driving skills and on driving performance in an on-road driving test. METHOD: 40 depressed inpatients treated with agomelatine (n = 20) or venlafaxine (n = 20) were tested before pharmacological treatment (t0), and on days 14 (t1) and 28 (t2). 20 healthy subjects were examined in the same time schedule to control for retest effects in psychomotor measures. Additionally, participants were rated in a standardized on-road driving test on day 28 by a licensed driving instructor, who was blind with respect to treatment, diagnosis and test results. RESULTS: After 4 weeks of treatment (t2) with agomelatine or venlafaxine, patients showed a significant reduction in depressive symptoms, and a distinct improvement in psychomotor functions. Controlling for retest effects in psychomotor measures, data indicate, that both patient groups significantly improved in tests measuring reactivity and stress-tolerance. Furthermore, prior discharge to outpatient treatment (day 28), 72.5% of patients were labeled abundantly fit to drive in the on-road driving test by a licensed driving instructor. However, patients did not reach the performance level of healthy controls in functional domains tested. Significant differences between treatment groups were not observed. CONCLUSION: Our results indicate that depressed inpatients treated with agomelatine or venlafaxine show a better test performance on tasks related to driving skills than do untreated depressives and could predominantly be rated as fit to drive on an actual driving test prior discharge to outpatient treatment.

[Dementia and driving]. / Demenz und Autofahren.

For most people driving is essential for mobility to maintain independence and to take part in activities of daily living. Ageing per se does not impair driving but in cases of medical conditions, such as cognitive impairment and dementia, driving safety can be impaired. Thus clinicians are often called upon to counsel patients and to make recommendations on their fitness to drive. Dementia in the early stages of the illness does not necessarily preclude driving ability. Patients with mild dementia pose a risk with respect to traffic safety and an individual assessment with regular follow-up investigations should be made. Especially patients with frontotemporal dementia should cease driving early in the course of the disease. Screening tests that focus on visuospatial abilities, attention and executive functions can improve the prediction of driving ability in patients with dementia. In many cases an on-road driving test to evaluate the ability to compensate for functional impairments is essential. In order to preserve personal autonomy as long as possible patients should be individually counselled taking into account driving experience, insight into functional impairments, personality and the capability to compensate for functional disabilities.

[Current status of cognition-based interventions in Alzheimer's disease]. / Kognitionsbezogene Interventionen bei Alzheimer-Krankheit: Aktueller Stand und Perspektiven.

At present more than 1 million patients in Germany suffer from Alzheimer's disease (AD). This number is expected to double by 2050. The effectiveness of presently approved specific antidementive drugs for symptomatic treatment of AD is still not satisfactory. The question arises whether cognition-based nonpharmacologic measures may constitute an effective intervention in AD and its prodromal stages. The paper at hand defines theoretical general principles of cognitive training and gives an overview of recent findings that provide evidence of its effectiveness. We finally present recommendations for future studies and establishment of cognitive training.