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1.
Article in English | MEDLINE | ID: mdl-38851655

ABSTRACT

Ethanol is metabolized by alcohol dehydrogenase to acetaldehyde and induces cytochrome P450 2E1 (CYP2E1), which generates reactive oxygen species that cause inflammatory liver damage. Clomethiazole, a drug approved for alcohol withdrawal treatment (AWT) in some European countries, inhibits CYP2E1. We hypothesized that clomethiazole would lead to a faster reduction in oxidative stress, inflammatory cytokines, and liver enzymes compared to diazepam treatment. We analysed respective biomarkers in 50 patients undergoing AWT and 25 healthy individuals but found no statistical difference between the two medication groups over 3-5 days. Hence, our hypothesis was not confirmed during this observation period.

2.
Psychiatr Prax ; 50(S 01): S4-S6, 2023 Jul.
Article in German | MEDLINE | ID: mdl-37429275

ABSTRACT

The essential philosophical theories about love are contained in a poem and a fable. Although there are many connections between love, psychological experience and psychiatric disorders, love seems to be suspect in psychiatry. Possibly it is a basic complex of psychiatry not only to withdraw from love, but also to exclude the fundamental issues of sexuality and parenting of the mentally ill.


Subject(s)
Love , Mental Disorders , Humans , Germany , Sexuality/psychology , Sexual Behavior , Mental Disorders/diagnosis , Mental Disorders/therapy
3.
Psychiatr Prax ; 50(S 01): S7-S14, 2023 Jul.
Article in German | MEDLINE | ID: mdl-37429276

ABSTRACT

With reference to a poem "Dialogue between two lovers" and a fable "The Last Love", essential aspects of love are described: love as access to the world, as a path to wisdom, self-knowledge and virtue, love as fear of loss and the desire to merge, love as encounter in dialogue, love as care, love as ecstasy, a feeling of pleasure and happiness. These are based on three theories of love from the beginnings of philosophy in ancient Greece by Plato and Aristotle. In the article they are considered from a philosophical-psychiatric perspective and supplemented by newer interpretations. With the help of a brief description of individual psychiatric disorders, a new understanding of love has been formulated. Ethical reflections on love life in psychiatry suggest that love in psychiatry is subject to a taboo, despite the creative possibilities it offers. Possible causes are discussed at the end. The article encourages thinking about love in psychiatry.


Subject(s)
Love , Psychiatry , Humans , Germany , Philosophy , Happiness
4.
Nervenarzt ; 93(7): 695-705, 2022 Jul.
Article in German | MEDLINE | ID: mdl-35254465

ABSTRACT

BACKGROUND: Over the past 20 years the importance of treatment of people with mental and neurological disorders has greatly increased. Parallel to this development it has become more difficult to attract young physicians to this field. The aim of this study was to examine the development of the number of physicians specialized in the care of patients suffering from neurological, mental and psychosomatic disorders with special consideration of the age structure. MATERIAL AND METHODS: The analyses were based on the number of professionally active physicians and specialized physicians published by the German Medical Association for the years 2000-2020. Separate age groups were looked at for psychiatry and psychotherapy (PPT), psychosomatic medicine and psychotherapy (PMPT), Nervenheilkunde (formerly psychiatry and neurology together, NHK) and neurology. RESULTS: In comparison to the year 2000 the number of specialized physicians working in PPT (4736 vs. 12,053), neurology (2226 vs. 8355) and PMPT (3543 vs. 4130) increased in 2020, while the number of specialists actively working in NHK decreased (5184 vs. 2301). Parallel to this the proportion of women increased. Dramatic changes occurred concerning the age structure. Currently, 77.7% of specialists working in NHK and 59.7% working in PMPT are over 60 years old. In 2020 there were 2988 specialists aged over 60 years in the discipline of PPT compared to only 1070 under 40 years, which is dramatically different from 20 years earlier when only 181 were over 60 years but 1491 were under 40 years old. CONCLUSION: The overaging of professional specialists and the shortage of junior physicians jeopardize modern and adequate provision of care for mentally ill patients. Possible solutions include a marked increase in medical school capacities as well as strategies to convince young physicians to work in the disciplines of PPT and PMPT.


Subject(s)
Physicians , Psychiatry , Psychosomatic Medicine , Adult , Aged , Female , Humans , Mental Health , Middle Aged , Specialization
5.
Psychiatr Prax ; 48(S 01): S48-S50, 2021 Mar.
Article in German | MEDLINE | ID: mdl-33652488

ABSTRACT

The satirical story describes how the first person became "conscious".


Subject(s)
Consciousness , Germany , Humans , Male
6.
Psychiatr Prax ; 48(S 01): S51-S57, 2021 Mar.
Article in German | MEDLINE | ID: mdl-33652489

ABSTRACT

The structure of relationships in the past, the present and the future is shaped by the idea of humanism. Based on this construct, the article illuminates various aspects and configurations of humanism on a timeline from "here and now" to "there and then". The current reality of care goes hand in hand with an emotional alienation of relationships. Advances in technology and reductionist neurobiological ideas can make it difficult to look at a person's mental illness as a whole. Any (communication) technology that has been developed in the past or will be developed in the future will sooner or later find its way into psychiatry and psychotherapy and change relationships. Transhumanism runs the risk that people will become alienated from each other and their species. Neural networks are algorithms that work regardless of the hardware used, be it based on organic carbon units such as humans or non-organic silicon units such as the computer/cyborg. There will be different ways to achieve super intelligence. Intelligence is a "must" and consciousness is a "can". If there is a change from a homocentric to a data-centered world view and the power of humans is transferred to the algorithms, humans could lose their economic value and the humanistic goals of health and happiness would be lost.


Subject(s)
Artificial Intelligence , Psychiatry , Algorithms , Emotional Intelligence , Germany , Humans
7.
Psychiatr Prax ; 46(3): 156-161, 2019 Apr.
Article in German | MEDLINE | ID: mdl-30641610

ABSTRACT

BACKGROUND: Psychotherapy is an essential part of treating people with mental illness. However, the implementation of psychotherapeutic interventions in the field of inpatient psychiatric treatment remains well behind demand. At the same time, the use of psychotherapeutic interventions by other professional groups - such as social workers and nursing - is not a common practice in Germany. OBJECTIVE: What can we learn from the international research with regard to nursing for Germany in view of the insufficient supply of psychotherapeutic care. METHOD: Based on a literature analysis, the German situation of care is related to international developments and a German training curriculum is presented. RESULT: A look at the international literature shows that in other countries especially trained nurses perform psychotherapeutic Interventions. In addition, there are effective training curricula whose transferability to Germany appears to be possible after appropriate adjustments.An 18 months lasting training program for nurses is presented. In addition to disorder-specific competences, this curriculum also provides psychotherapeutic interventions with a general approach. CONCLUSION: Collaborative care in the collaboration of different health professionals has been repeatedly and stably proven to be effective and helpful in treating people with various mental disorders. In order to better meet the growing need for psychotherapeutic interventions in the population in the sense of a stepped care model, trained nurses need to be more involved in the provision of psychotherapeutic services.


Subject(s)
Inpatients , Mental Disorders , Psychiatric Nursing , Psychotherapy/methods , Germany , Hospitalization , Humans , Inpatients/psychology , Mental Disorders/therapy
8.
Psychiatr Prax ; 45(S 01): S5-S9, 2018 07.
Article in German | MEDLINE | ID: mdl-29969812

ABSTRACT

Starting with the fairy-tale "Hans in luck" some scientific basics of social economy, neurobiology, psychology, psychiatry, and philosophy in the context of happiness are elucidated and from a personal point of view assigned to a moral, an aesthetic, an intellectual, and a spiritual dimension as fundamental principles of the human living together.


Subject(s)
Happiness , Psychiatry , Germany , Humans , Morals , Philosophy
9.
Psychiatr Prax ; 45(S 01): S41-S45, 2018 07.
Article in German | MEDLINE | ID: mdl-29969819

ABSTRACT

Ethical aspects towards the parenthood of mentally ill patients will be discussed in the German health care system. The "concept of an ethical therapist" offers new perspectives for solutions concerning the individual level. Structural and systemic problems require institutional and political configurations. The "ethical compass of psychiatric parenthood" points the dimensions of autonomy, heteronomy, egoism, and public spirit. Reductions of psycho-social burden, an age-dependent differentiated prevention und early external assessment contribute to successful parenthood of mentally ill patients.


Subject(s)
Mental Disorders , Mentally Ill Persons , Parenting/psychology , Germany , Humans , Mentally Ill Persons/psychology , Morals
10.
Eur Arch Psychiatry Clin Neurosci ; 268(2): 129-143, 2018 Mar.
Article in English | MEDLINE | ID: mdl-27913877

ABSTRACT

Oxidative stress and immune dysregulation have been linked to schizophrenia and depression. However, it is unknown whether these factors are related to the pathophysiology or whether they are an epiphenomenon. Inconsistent oxidative stress-related findings in previous studies may have resulted from the use of different biomarkers which show disparate aspects of oxidative stress. Additionally, disease severity, medication, smoking, endocrine stress axis activation and obesity are potential confounders. In order to address some of these shortcomings, we have analyzed a broader set of oxidative stress biomarkers in our exploratory study, including urinary 8-iso-prostaglandin F2α (8-iso-PGF2α), 8-OH-2-deoyxguanosine (8-OH-2-dG), and blood levels of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione S-transferase (GST) in acutely ill drug-naïve first episode patients with schizophrenia (n = 22), major depression (n = 18), and controls (n = 43). Possible confounding factors were considered, and patients were followed-up after 6 weeks of treatment. No differences were observed regarding 8-OH-2-dG, MDA and GST. At baseline, 8-iso-PGF2α levels were higher in patients with schizophrenia (p = 0.004) and major depression (p = 0.037), with a trend toward higher SOD concentrations in schizophrenia (p = 0.053). After treatment, schizophrenia patients showed a further increase in 8-iso-PGF2α (p = 0.016). These results were not related to age, sex, disease severity, medication or adipose tissue mass. However, 8-iso-PGF2α was associated with smoking, endocrine stress axis activation, C-reactive protein levels and low plasma concentrations of brain-derived neurotrophic factor. This study suggests a role of lipid peroxidation particularly in drug-naïve acutely ill schizophrenia patients and highlights the importance of taking into account other confounding factors in biomarker studies.


Subject(s)
Depressive Disorder, Major/physiopathology , Oxidative Stress/physiology , Schizophrenia/physiopathology , Adult , Depressive Disorder, Major/metabolism , Dinoprost/analogs & derivatives , Dinoprost/urine , Female , Follow-Up Studies , Glutathione Transferase/blood , Humans , Male , Malondialdehyde/blood , Middle Aged , Psychiatric Status Rating Scales , Schizophrenia/metabolism , Statistics, Nonparametric , Superoxide Dismutase/blood
11.
Psychiatr Prax ; 41 Suppl 1: S1-7, 2014 Jul.
Article in German | MEDLINE | ID: mdl-24983568

ABSTRACT

Diversity and complexity of ethical problems in the psychiatric-psychotherapeutic field require ethical competences in all structures of the public health system. The knowledge of ethical examples and principles including basics of philosophy may offer bearing and will be helpful to develop a personal and social ethical attitude.


Subject(s)
Ethics, Medical , Philosophy, Medical , Psychiatry/ethics , Psychotherapy/ethics , Humans
13.
Psychiatr Prax ; 41 Suppl 1: S86-8, 2014 Jul.
Article in German | MEDLINE | ID: mdl-24983584

ABSTRACT

The relationship between social attitudes, normative ethics, health care elite's and individual failure has been highlighted in a scenario for patients with dementia. Inhuman abuse may be protected by sense of responsibility, duty to social being, inclusion of psychiatric patients, and the foundation of human dignity.


Subject(s)
Community Integration/trends , Dementia/rehabilitation , Ethical Theory , National Health Programs/trends , Personhood , Psychiatry/trends , Social Responsibility , Aged , Community Integration/ethics , Community Integration/legislation & jurisprudence , Community Integration/psychology , Dementia/diagnosis , Dementia/psychology , Ethics, Medical , Forecasting , Germany , Humans , National Health Programs/ethics , National Health Programs/legislation & jurisprudence , Personal Autonomy , Psychiatry/ethics , Psychiatry/legislation & jurisprudence , Social Values
14.
JAMA Psychiatry ; 70(3): 271-8, 2013 Mar.
Article in English | MEDLINE | ID: mdl-23344076

ABSTRACT

CONTEXT: Evidence for symptomatic convergence of schizophrenia and N-methyl-D-aspartate glutamate receptor (NMDA-R) encephalitis highlights the need for an assessment of antibody prevalence and specificity for distinct disease mechanisms in patients with a diagnosis of schizophrenia among glutamatergic pathophysiologic abnormalities in psychiatric disorders. OBJECTIVES: To compare the specificity and prevalence of NMDA-R antibodies in schizophrenia (DSM-IV criteria) with those of other psychiatric diagnoses and to determine whether antibody subtypes characterize overlap with and distinction from those in NMDA-R encephalitis. DESIGN: Serum from 459 patients admitted with acute schizophrenia, major depression (MD), and borderline personality disorder (BLPD) or individuals serving as matched controls was obtained from our scientific blood bank. To explore epitope specificity and antibody subtype, IgA/IgG/IgM NMDA-R (NR1a or NR1a/NR2b) and α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate receptors (AMPA-R) (GluR1/GluR2) serum antibodies were determined. PARTICIPANTS: Two hundred thirty matched healthy controls were compared with patients (unmedicated for at least 6 weeks) with schizophrenia (n = 121), MD (n = 70), or BLPD (n = 38). MAIN OUTCOME MEASURES: The primary outcome was the overall number of seropositive cases for NMDA-R and AMPA-R antibodies; the secondary outcome was disease specificity of IgA/IgG/IgM antibodies and epitope specificity for clinical subgroups. RESULTS: Diverse NMDA-R antibodies were identified in 15 subjects, primarily those with an initial schizophrenia diagnosis (9.9%), opposed to MD (2.8%), BLPD (0), and controls (0.4%). Retrospectively, 2 patients initially classified as having catatonic or disorganized schizophrenia were reclassified as having misdiagnosed NMDA-R encephalitis (presence of specific serum and cerebrospinal fluid IgG NR1a antibodies). In all other seropositive cases, the antibodies consisted of classes IgA and/or IgM or were directed against NR1a/NR2b (not against NR1a alone). None of the patients or controls had antibodies against AMPA-R. CONCLUSIONS: Acutely ill patients with an initial schizophrenia diagnosis show an increased prevalence of NMDA-R antibodies. The repertoire of antibody subtypes in schizophrenia and MD is different from that with NMDA-R encephalitis. The latter disorder should be considered as a differential diagnosis, particularly in young females with acute disorganized behavior or catatonia.


Subject(s)
Autoantibodies/blood , Immunoglobulin G/blood , Receptors, AMPA/immunology , Receptors, N-Methyl-D-Aspartate/immunology , Schizophrenia , Adult , Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/immunology , Case-Control Studies , Depressive Disorder, Major/diagnosis , Depressive Disorder, Major/immunology , Encephalitis/diagnosis , Encephalitis/immunology , Female , Humans , Immunoglobulins/blood , Male , Middle Aged , Schizophrenia/diagnosis , Schizophrenia/immunology , Sensitivity and Specificity
15.
Brain Behav Immun ; 26(8): 1273-9, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22917959

ABSTRACT

Certain cytokines have been identified in the peripheral blood as trait markers of schizophrenia, while others are considered relapse-related state markers. Furthermore, data from peripheral blood, cerebrospinal fluid (CSF) and nuclear imaging studies suggest that (1) blood-brain barrier (BBB) dysfunction (e.g., immigration of lymphocytes into brain tissue and intrathecal antibody production) correlates with the development of negative symptoms, while (2) the brain's mononuclear phagocyte system (microglial cells) is activated during acute psychosis. Based on these neuroinflammatory hypotheses, we have quantified the numerical density of immunostained CD3+ T-lymphocytes, CD20+ B-lymphocytes, and HLA-DR+ microglial cells in the posterior hippocampus of 17 schizophrenia patients and 11 matched controls. Disease course-related immune alterations were considered by a separate analysis of residual (prevailing negative symptoms, n=7) and paranoid (prominent positive symptoms, n=10) schizophrenia cases. Higher densities of CD3+ and CD20+ lymphocytes were observed in residual versus paranoid schizophrenia (CD 3: left: P=0.047, right: P=0.038; CD20: left: P=0.020, right: P=0.010) and controls (CD3: left: P=0.057, right: P=0.069; CD20: left: P=0.008, right: P=0.006). In contrast, HLA-DR+ microglia were increased in paranoid schizophrenia versus residual schizophrenia (left: P=0.030, right: P=0.012). A similar trend emerged when this group was compared to controls (left: P=0.090, right: P=0.090). BBB impairment and infiltration of T cells and B cells may contribute to the pathophysiology of residual schizophrenia, while microglial activation seems to play a role in paranoid schizophrenia. The identification of diverse immune endophenotypes may facilitate the development of distinct anti-inflammatory schizophrenia therapies to normalize BBB function, (auto)antibody production or microglial activity.


Subject(s)
Hippocampus/immunology , Lymphocytes/immunology , Microglia/immunology , Schizophrenia, Paranoid/immunology , Antigens, CD20/metabolism , Autopsy , Blood-Brain Barrier/immunology , Blood-Brain Barrier/metabolism , Disease Progression , HLA-DR Antigens/immunology , HLA-DR Antigens/metabolism , Hippocampus/cytology , Hippocampus/metabolism , Humans , Lymphocytes/cytology , Lymphocytes/metabolism , Microglia/cytology , Microglia/metabolism
16.
Psychiatr Prax ; 39(5): 205-10, 2012 Jul.
Article in German | MEDLINE | ID: mdl-22581675

ABSTRACT

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.


Subject(s)
Delivery of Health Care/economics , Delivery of Health Care/organization & administration , Maternal-Child Health Centers/economics , Maternal-Child Health Centers/organization & administration , Mental Disorders/therapy , National Health Programs/economics , National Health Programs/organization & administration , Pregnancy Complications/therapy , Cooperative Behavior , Education , Female , Financing, Government/economics , Financing, Government/trends , Germany , Health Policy/economics , Health Policy/trends , Health Services Needs and Demand/economics , Humans , Infant , Infant, Newborn , Interdisciplinary Communication , Mother-Child Relations , Patient Admission , Patient Care Team , Pregnancy , Psychiatric Department, Hospital/economics , Psychiatric Department, Hospital/organization & administration , Reimbursement Mechanisms/economics , Reimbursement Mechanisms/organization & administration , Rooming-in Care , Surveys and Questionnaires
17.
Brain Behav Immun ; 26(4): 564-7, 2012 May.
Article in English | MEDLINE | ID: mdl-22326439

ABSTRACT

Several studies have provided evidence for increased S100B serum concentrations in schizophrenia. The pathophysiological significance of this finding is still uncertain because S100B is involved in many cellular mechanisms and is not astrocyte-specific as was previously assumed. S100B is also expressed by subsets of CD3+ CD8+ T cells and natural killer (NK) cells and may therefore be linked to the immune hypothesis of schizophrenia. We have quantified S100B+ CD3+ CD8+ T cells and NK cells by flow cytometry in the peripheral blood of 26 acutely ill schizophrenia cases and 32 matched controls. In parallel, S100B concentrations and the free cortisol index (FCI), a surrogate marker for stress axis activity, were determined in serum samples from the same blood draw. Psychopathology was monitored using the Positive and Negative Syndrome Scale (PANSS). The patient group had increased S100B+ NK cell counts (P=0.045), which correlated with the FCI (r=0.299, P=0.026) but not with the PANSS or the elevated (P=0.021) S100B serum concentrations. S100B+ CD3+ CD8+ T cell counts were not significantly changed in the patient group and did neither correlate with the FCI and PANSS, nor with S100B serum concentrations. In conclusion, despite the observation of an increase in S100B+ NK cells in schizophrenia patients, the lack of a correlation with serum S100B concentrations suggests that these cells are probably not a major source of S100B in the blood of schizophrenia patients. Notably, elevated S100B+ NK cell counts may be linked with stress axis activation.


Subject(s)
CD3 Complex/immunology , CD8-Positive T-Lymphocytes/immunology , Hydrocortisone/blood , Killer Cells, Natural/immunology , Nerve Growth Factors/immunology , S100 Proteins/immunology , Schizophrenia, Paranoid/immunology , Adult , Biomarkers/blood , Case-Control Studies , Female , Flow Cytometry , Humans , Lymphocyte Count , Male , Middle Aged , Nerve Growth Factors/blood , S100 Calcium Binding Protein beta Subunit , S100 Proteins/blood , Schizophrenia, Paranoid/blood , Stress, Psychological , T-Lymphocyte Subsets
18.
Psychiatr Prax ; 38 Suppl 2: S1-7, 2011 Nov.
Article in German | MEDLINE | ID: mdl-22006449

ABSTRACT

Current psychiatric-psychotherapeutic in-patient care takes place in an area of tension between increasing treatment requirements and the persistent lack of qualified staff. The optimisation of the diagnostic-therapeutic procedures in a clinic helps to reduce existing care deficits or to generate resources for future developments. The subject of delegation and substitution of medical services is considered in this context. Inadequate knowledge of the legal situation on the part of the decision makers impairs the indispensable trustful cooperation among the professions and adds to the uncertainty of all those concerned. The present paper outlines the legal, organisational and health policy aspects of delegation and the reorganisation of medical activities in the field of psychiatry.


Subject(s)
Delegation, Professional/legislation & jurisprudence , Delegation, Professional/organization & administration , Health Services Needs and Demand/legislation & jurisprudence , Health Services Needs and Demand/organization & administration , Hospitals, Psychiatric/legislation & jurisprudence , Hospitals, Psychiatric/organization & administration , Mental Disorders/therapy , Psychiatry/legislation & jurisprudence , Psychiatry/organization & administration , Quality Assurance, Health Care/legislation & jurisprudence , Quality Assurance, Health Care/organization & administration , Clinical Competence/legislation & jurisprudence , Cooperative Behavior , Cross-Sectional Studies , Expert Testimony/legislation & jurisprudence , Germany , Humans , Interdisciplinary Communication , Medical Errors/legislation & jurisprudence , Medical Staff, Hospital/legislation & jurisprudence , Medical Staff, Hospital/organization & administration , Mental Disorders/diagnosis , Mental Disorders/epidemiology , Nursing Staff, Hospital/legislation & jurisprudence , Nursing Staff, Hospital/organization & administration , Psychiatric Nursing/legislation & jurisprudence , Psychiatric Nursing/organization & administration , Workforce , Workload/legislation & jurisprudence
19.
Psychiatr Prax ; 38 Suppl 2: S8-15, 2011 Nov.
Article in German | MEDLINE | ID: mdl-22006450

ABSTRACT

Based on legal jurisdiction, knowledge of the psychiatric-psychotherapeutic field and insight into the necessity of a new allocation of responsibilities in the overall therapeutic service of a clinic, the core areas of medical activities are defined for the first time, innovative organisational approaches to the reorganisation of therapeutic service are presented and discussed against the background of qualified staff deficit, introduction of an OPS coding for inpatient psychiatry and economic constraints.


Subject(s)
Clinical Competence/legislation & jurisprudence , Delegation, Professional/legislation & jurisprudence , Hospitals, Psychiatric/legislation & jurisprudence , Mental Disorders/diagnosis , Mental Disorders/therapy , National Health Programs/legislation & jurisprudence , National Health Programs/organization & administration , Psychiatry/legislation & jurisprudence , Cross-Sectional Studies , Germany , Health Services Needs and Demand/legislation & jurisprudence , Health Services Needs and Demand/organization & administration , Hospitals, Psychiatric/organization & administration , Humans , Inservice Training , Mental Disorders/epidemiology , Mentors/legislation & jurisprudence , Personnel Selection/legislation & jurisprudence , Psychiatric Nursing/education , Psychiatric Nursing/legislation & jurisprudence , Psychiatric Nursing/organization & administration , Psychiatry/education , Psychiatry/organization & administration , Psychotherapy/education , Psychotherapy/legislation & jurisprudence , Psychotherapy/organization & administration , Quality Assurance, Health Care/legislation & jurisprudence , Quality Assurance, Health Care/organization & administration , Workload
20.
Psychiatr Prax ; 38 Suppl 2: S16-24, 2011 Nov.
Article in German | MEDLINE | ID: mdl-22006451

ABSTRACT

Increasing psychiatric disorder treatment need, increased work load, changes in the working hour regulations, the nation-wide shortage of physicians, efficiency principle and economisation can necessitate a reorganisation of medical services. The essential steps and instruments of process optimisation in medical services for a psychiatric clinic are elucidated and discussed in the context of demographic changes, generation change, and a new concept of values.


Subject(s)
Delegation, Professional/organization & administration , Hospitals, Psychiatric/organization & administration , Mental Disorders/diagnosis , Mental Disorders/therapy , National Health Programs/organization & administration , Psychiatric Department, Hospital/organization & administration , Psychiatry/organization & administration , Cooperative Behavior , Cross-Sectional Studies , Education/organization & administration , Forecasting , Germany , Guidelines as Topic , Health Services Needs and Demand/organization & administration , Humans , Interdisciplinary Communication , Mental Disorders/epidemiology , Population Dynamics , Psychiatry/education , Quality Assurance, Health Care/organization & administration , Work Schedule Tolerance , Workforce , Workload
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