[Assisting the Forgotten Ones - Interventions for Children of Parents with Psychological Disorders]. / Nicht von schlechten Eltern ­ Interventionen und Hilfsangebote für Kinder psychisch kranker Eltern.

Assisting the Forgotten Ones - Interventions for Children of Parents with Psychological Disorders Mental diseases are associated with high levels of distress in various areas of life for those, who are affected. Taking a closer look at the social circumstances, not exclusively the people themselves but also their family members are affected, especially children. In adult treatment these children are often neglected, even if they have a higher risk of suffering a mental illness themselves. A huge amount of this risk is related to the special family environment children are often exposed to right after birth. We already find prevention programs helping these children and their parents to protect their mental health. These programs largely differ regarding parental psychopathology, setting or intensity. This article gives an overview of the special circumstances these children may be confronted with and hence derivates possible starting points to support affected families. A few existing programs will be described in detail. Empirical findings presented in the article give hope for the effectiveness of already existing programs and besides highlight the need for further research and changes in the care system.

[A Patient´s Personality: A Frequently Ignored but Important Component in General Medical Practice]. / Die Persönlichkeit des Patienten: Eine oft vernachlässigte aber bedeutsame Komponente in der allgemeinmedizinischen Praxis.

A Patient´s Personality: A Frequently Ignored but Important Component in General Medical Practice Abstract. In general medical practice, a patient's personality is hardly considered and assessed. In this mini-review the author summarises how a comprehensive personality assessment may provide valuable patient information. Prospective effects of personality traits on general lifestyle as well as mental and physical health are presented. In addition, original research is introduced that shows meaningful associations between personality traits, clinical disease markers, and all-cause mortality. These findings are discussed with respect to selected etiological models. The studies illustrate that a personality assessment could be a useful aid for diagnosis, prognosis, and treatment planning.

[Do Attachment Styles of Mentally Ill Parents Impact on the Health-related Quality of Life of their Children?]. / Beeinflusst der elterliche Bindungsstil die gesundheitsbezogene Lebensqualität der Kinder psychisch kranker Eltern?

Do Attachment Styles of Mentally Ill Parents Impact on the Health-related Quality of Life of their Children? Parents with a mental disorder often display a problematic attachment style which may impact on their children's health related quality of life (HrQoL). The current study cross-sectionally examines attachment styles (BEPE) in mentally ill parents with underage children (n = 62) and the effect of attachment on their children's HrQoL (KINDL-R). Results show that secure attachment is less represented in parents with a mental health condition than in a healthy reference group. Within the clinical sample, children of mentally ill parents with a secure attachment style exhibit a higher HrQoL than children of mentally ill parents with ambivalent or avoidant attachment styles. These findings indicate not only that problematic attachment styles frequently occur in families with a mentally ill parent, but also suggest that this negatively affects the children's HrQoL. Appropriate interventions should include attachment oriented concepts.

[Attachment Quality of Young Children with Mentally Ill Parents on the Example of the Munchausen by Proxy Syndrome]. / Bindungsqualität von Kleinstkindern psychisch kranker Eltern am Beispiel des Münchhausen by Proxy Syndroms/ Attachment Quality of Young Children with Mentally Ill Parents on the Example of the Munchausen by Proxy Syndrome.

One of the most discussed questions in clinical literature concerns the impact of child abuse by mentally ill parents (cf. Mattejat, 1998). It's obvious that most children cannot understand such a parental behaviour and that this lack of understanding along with the lack of knowledge about their parents' emotional disorder results in childrens' fear, disorientation and uncertainty. The consequences are massive interferences in the relationship between parents and children, who could develop an anxious-resistant insecure or even a disorganized/disoriented attachment. But how does a child react, if the behaviour of its parents is ambivalent itself and alternates from abuse to care? Such a parental behaviour is described as the "Munchausen by Proxy Syndrome". This article regards the effects of a "Munchausen by Proxy Syndrome" on the childrens' attachment development. After discussing the basic assumptions about the "Munchhauen by Proxy Syndrome" and the attachment theory we draw conclusions about the syndrome's effect on childrens' attachment behaviour.

[Inclusion - pediatric and adolescent psychiatry aspects]. / Inklusion - kinder- und jugendpsychiatrische Aspekte.

The Convention on the Rights of Persons with Disabilities became legally binding in Germany in March 2009. "Inclusion" is the major concept­all people with any kind of handicap must have the same rights to full and effective participation and inclusion in society. Preceding inclusion come adjustments in society with regard to ethical, legislative, administrative, conceptual, structural, economical, and thus also to healthcare-political frameworks, in order to make disabilities are as far as possible no longer a handicap in an individual's everyday life. This review first outlines the present social status influencing the development of children, a child's welfare, and especially the healthcare of children and adolescents with psychiatric disorders and conditions indicating barriers to inclusion. It focuses on those articles of the UN convention which are relevant with regard to ethical attitude, epidemiology, healthcare framework, diagnostics, therapy, teaching, and research with respect to child and adolescent psychiatry. The analysis points to a significant backlog demand in child psychiatric healthcare, teaching, and research.

Modelos animais em psiquiatria: avanços e desafios / Animal models in psychiatry: advances and challenges / Les modèles animaux en psychiatrie: progrès et défis / Los modelos animales en psiquiatría: avances y desafios

Objetivos: Discutir os avanços e limitações do uso dos modelos animais nos transtornos psiquiátricos. Método: Uma revisão narrativa de artigos. Resultados: Diferentes modelos animais atualmente demonstram validade adequada para características específicas de determinados transtornos mentais. Conclusão: Resguardadas as devidas limitações que impossibilitam mimetizar sintomas psicopatológicos complexos em modelos animais, estes seguem como úteis ferramentas de estudo na psiquiatria.

Objectives: To discuss the advances and limitations of animal models in psychiatric disorders. Method: A narrative review of articles. Results: Different animal models currently demonstrate adequate validity for specific characteristics of certain mental disorders. Conclusion: Recognizing limitations that stay away from any mimicking of complex psychopathological symptoms in animal models, such models nonetheless represent useful tools in the study of psychiatry.

Objectifs: Examiner les progrès et les limites des modèles animaux pour l'étude des troubles psychiatriques. Méthode: Révision narrative d'articles. Résultats: De différents modèles animaux possèdent actuellement une validité suffisante par rapport aux caractéristiques spécifiques de certains troubles mentaux. Conclusion: Malgré le fait des limites qui ne permettent pas de reproduire les symptômes psychopathologiques complexes dans les modèles animaux, ceux-ci restent néanmoins des outils utiles d'étude en psychiatrie.

Objetivos: Discutir los avances y las limitaciones de los modelos animales en los trastornos psiquiátricos. Método: Una revisión narrativa de artículos. Resultados: Los diferentes modelos animales actualmente demuestran validez adecuada para las características específicas de determinados trastornos mentales. Conclusión: Guardadas las debidas limitaciones que imposibilitan mimetizar los síntomas psicopatológicos complejos en modelos animales, estes siguen siendo herramientas útiles en el estudio de la psiquiatría.

[Quality of involuntary hospital administration in Switzerland]. / Qualität unfreiwilliger Klinikeinweisungen in der Schweiz.

SUBJECT: This study aims at investigating the formal and content-related quality of medical certificates directing compulsory hospital admissions before the scheduled alteration of the Swiss civil legislation in January 2013. A comparison between physicians with different professional backgrounds concerning certificates and patients was conducted. METHODS: Retrospective investigation of medical records of involuntary inpatients at the University Hospital of Psychiatry in Zurich during a period of six months (N=489). RESULTS: Considerable deficits concerning formal and particularly content-related aspects of the certificates were found. Psychiatrists issued certificates of the highest quality followed by emergency physicians, hospital doctors and general practitioners. Patients differed with respect to several sociodemographic and clinical variables. CONCLUSIONS: The quality of certificates directing involuntary hospital admission has to be improved considering the impact on the individual concerned. The consequences of the new legislation on the quality of the admission practices should be inquired in order to improve professional training on the issue.

Objectif: Le but de cette étude est d'analyser la pratique des admissions non-volontaires à l'aide de critères d'un point de vue formel et du contenu des demandes d'hospitalisation d'office avant l'introduction de la nouvelle loi sur la protection de l'adulte et de l'enfant en janvier 2013. Les aspects pouvant indiquer des différences entre les médecins demandeurs de domaines médicaux divers sont examinés et les personnes admises caractérisées. Méthode: Analyse rétrospective des demandes d'admissions non-volontaires et des dossiers médicaux de tous les patients admis d'office à l'hôpital psychiatrique universitaire de Zürich dans un intervalle de six mois (N=489). Résultats: Il existe des défauts considérables concernant les critères de qualité d'un point de vue formel et surtout du contenu. Les médecins psychiatres établissent les certificats de meilleure qualité suivis par les médecins d'urgence, ainsi que les médecins travaillant en milieu hospitalier et les médecins généralistes. Les patients de ces groupes se distinguent quant à des variables cliniques et sociodémographiques. Conclusions: La qualité des demandes d'admission non-volontaire sur un point de vue formel et surtout du contenu est à améliorer au vu des conséquences éthiques et juridiques graves pour les patients concernés. Les répercussions de la nouvelle loi sur la qualité des admissions sont à revoir, pour que des défauts éventuels dans la pratique des mesures contraignantes puissent être abordées dans la formation postgraduée et continue.