[Cannabis use in adolescents : Narrative Review and Position paper of the "Addiction Disorders in Adolescents" task force of the Austrian Society for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy (ÖGKJP)]. / Cannabisgebrauch bei Jugendlichen : Übersicht und Positionspapier der Arbeitsgruppe "Suchtstörungen im Jugendalter" der Österreichischen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie (ÖGKJP).

BACKGROUND: Cannabis is the illegal drug most frequently used by Minors in Austria. Due to the gradual decriminalization and legalization that has taken place in many European countries in recent years, the ÖGKJP would like to take a balanced and scientifically based stand on the complex issue of cannabis use and abuse among young people. METHODS: The authors searched the medline for current studies using searches tailored to each specific subtopic. Furthermore, recognized compendiums were quoted. RESULTS: While occasional recreational use of cannabis in adults with completed brain maturation and no risk profile for mental disorders is likely to be relatively harmless, early initiation of use with regular use and the increasingly available, highly potent cannabis varieties can lead to explicit and sometimes irreversible neurocognitive brain dysfunction. CONCLUSION: Legalisation of cannabis consumption for minors needs to be objected to due to the risks of the expected damage in the area of brain development. At the same time, however, it is important to establish sensible legal regulations in order to be able to adequately counteract the fact that over 30% of all European young people occasionally consume cannabis. We are also clearly recommending to not criminalize cannabis users and provide necessary support to vulnerable and addicted cannabis users.

Gender aspects of parents' needs of schizophrenia patients.

BACKGROUND: Most studies about the problems and needs of schizophrenia carers included only one care-giving relative, usually the patients' mothers. METHODS: 101 mothers and fathers of the same patients suffering from schizophrenia were included into this study. Their needs were assessed by means of the "Carers' Needs Assessment for Schizophrenia". RESULTS: Mothers reported significantly more often problems than fathers concerning stress due to earlier life events and burn-out. Mothers needed interventions such as individual psychoeducation or family counselling more than twice as often as fathers. Overall, mothers reported higher numbers of problems and needs for intervention than fathers. The number of mothers' problems was predicted by not living with a partner and by a shorter duration of the patients' illness. The number of mothers' needs was predicted by more psychiatric symptoms, not living with a partner and a shorter duration of the patients' illness. Among fathers we could not identify any predictors, neither for the number of problems nor for the number of needs. CONCLUSIONS: Fathers and mothers often report problems and frequently need professional support. Overall, mothers exhibited more problems and needs for interventions than fathers. The differences between mothers and fathers indicate the importance of considering the carer's gender in clinical work.

[Are there gender-specific differences between mothers and fathers caring for a schizophrenia patient?]. / Gibt es geschlechtsspezifische Unterschiede in der elterlichen Betreuung von Schizophrenie-Kranken?

OBJECTIVE: The purpose of this study was to investigate differences between mothers and fathers of patients with schizophrenia or schizoaffective disorders concerning the time spent with the patients as well as other aspects of caring. METHODS: 101 mothers and 101 fathers of the same patients suffering from schizophrenia or schizoaffective disorders according to ICD-10 were investigated. RESULTS: The mean time spent in personal (i.e. face-to-face) or telephone contact with patients was significantly higher for mothers than for fathers. About the half of the mothers spent more time with the patients than the fathers, while 12% of fathers spent more time than the mothers. Among 40% of patients, mothers and fathers spent an equal amount of time for personal or telephone contact with the patients. Concerning other aspects of caring (legal representative of the patient, payment for patient's costs, caring for the patient's household) we could not find any differences between mothers and fathers. CONCLUSIONS: Concerning several aspects we could not confirm that mothers are more involved into the patients' care than the fathers. These findings are in contrast to the usual assumptions about familial caregivers based on the traditional gender-specific role models.

One-year outcome of low-intensity booster sessions versus care as usual in psychosis patients after a short-term psychoeducational intervention.

OBJECTIVE: In this study we aimed to evaluate long-term effects of a community-based, quality of life oriented psychoeducational intervention for schizophrenia with and without booster sessions. METHOD: One hundred and three outpatients with a diagnosis of schizophrenia or schizoaffective disorder completed a 9-week psychoeducational programme. At the end of the programme groups were block-randomised to either an extension programme comprising monthly booster sessions for a further nine months (booster condition) or routine clinical care with no further group meetings (non-booster condition). Outcome measures were applied before and after the seminar and at 6 and 12 months. RESULTS: Positive effects were observed after the short-term 9-week programme with regard to symptoms, knowledge about the illness, illness concept, control convictions and quality of life. These effects were retained over the 12-month period in both conditions. The only relevant difference between the booster and the non-booster conditions concerned external control convictions. CONCLUSION: Overall this 9-week programme has shown encouraging effects still present at 12 months after baseline independent of booster or non-booster conditions. Further studies are needed to explore whether a subgroup of patients, those with impaired neurocognitive and social functioning, can benefit significantly from booster sessions.

Patients' perspectives on what works in psychoeducational groups for schizophrenia: a qualitative study.

BACKGROUND: Psychoeducational groups are a common component of interventions in schizophrenia. AIMS: To explore patients' views about wanted and unwanted effects of group psychoeducation. METHOD: Subjective feedback of 103 participants of a psychoeducational intervention as well as data from two specific focus groups-one with "enthusiastic" and one with "critical" participants-were analyzed by means of qualitative content analysis. RESULTS: Participants emphasized the importance of information received and of exchanging information with others suffering from the same disorder. Positive effects on coping, activation and social interaction were reported. Perceived overemphasis on illness related information produced defensive reactions, whereas the integration of quality of life topics was appreciated. A pleasant group atmosphere and clinical stability were suggested as important determinants of success. CONCLUSIONS: Qualitative analyzses of participants' views help to understand the potentials of a psychoeducational intervention in schizophrenia.

["Knowing--enjoying--better living". A seminar for persons with psychosis to improve their quality of life and reduce their vulnerability]. / "Wissen--geniessen--besser leben". Ein Seminar für Psychoseerfahrene zur Verbesserung der Lebensqualität und Verringerung der Verletzlichkeit.

UNLABELLED: As a result of a recent paradigm change in medicine the improvement of quality of life has become a central goal of treatment next to reducing symptoms. In order to address this demand we designed a new psychoeducational program for outpatients, which -- in contrast to traditional psychoeducation -- attaches as much importance to quality of life topics as it does to illness related topics. The seminar was developed especially in view of the score resources available today. First results of the evaluation are presented. METHOD: Psychiatrists in the community are encouraged to refer patients suffering from schizophrenia or schizoaffective disorders to this psychoeducational program as an additional component to regular treatment. The program is carried out in 9 group sessions at weekly intervals with 6-8 group members. At the beginning and at the end of the seminar different objective and subjective outcomes were assessed and predictors for seminar success were identified. RESULTS: 98 participants could be included in data analysis. After completing the program the seminar participants had significantly more knowledge about the illness, a significantly better quality of life and significantly more competence and control. Furthermore there were changes in the illness concept: prejudices about medication decreased, confidence in medication increased, and beliefs about susceptibility to illness and to relapse increased. CONCLUSIONS: First experiences with a psychoeducational seminar for persons with psychosis, putting equal stress on disease related and quality of life topics are encouraging, but require further confirmation through a randomised controlled trial.

[Autocastration of a young schizophrenic man]. / Selbstkastration eines psychotischen Patienten - Eine entwicklungspsychopathologische Betrachtung.

OBJECTIVE: Self-mutilation of the genitals in man is a rare phenomenon mainly occurring in young males. The importance of conflicts about the male role, difficulties with the male identification in childhood and feeling of guilt for sexual offences are discussed in the literature. The influence of developmental crisis on this symbolic form of automutilation will be discussed in our case report. METHOD: We present a case of a young schizophrenic man whose illness started in adolescence. He committed genital automutilation already in early adolescence, as a young male he autocastrated himself. DISCUSSION: We demonstrate the connection of specific problems of development in adolescence and psychopathology. Autocastration will be discussed as a "psychotic" solution of the adolescent conflict of dependence. CONCLUSIONS: Developmental conflicts may be important pathoplastic factors who may lead to severe psychopathology and misbehavior. Additionally to a psychopharmacological treatment a specific adolescent- and conflictoriented psychotherapy for solving the developmental conflicts in young schizophrenic patients should be established.