The "DGPPN-Cohort": A national collaboration initiative by the German Association for Psychiatry and Psychotherapy (DGPPN) for establishing a large-scale cohort of psychiatric patients.

The German Association for Psychiatry and Psychotherapy (DGPPN) has committed itself to establish a prospective national cohort of patients with major psychiatric disorders, the so-called DGPPN-Cohort. This project will enable the scientific exploitation of high-quality data and biomaterial from psychiatric patients for research. It will be set up using harmonised data sets and procedures for sample generation and guided by transparent rules for data access and data sharing regarding the central research database. While the main focus lies on biological research, it will be open to all kinds of scientific investigations, including epidemiological, clinical or health-service research.

Adolescent attention deficit hyperactivity disorder and susceptibility to psychosis in adulthood: a review of the literature and a phenomenological case report.

AIM: In contrast to affective disorders, some forms of personality disorders and drug addiction, schizophrenia is commonly not considered to be a sequela of attention deficit hyperactivity disorder. However, attention deficit hyperactivity disorder and the prodromal stages of schizophrenia spectrum disorders do exhibit a number of common central features. To facilitate the early treatment of schizophrenic symptoms, the detection of discrete and subtle alterations in the prodromal stages of incipient psychoses is particularly important. METHODS: We review the literature on the prodromal symptoms of psychosis and present a case report, in which a phenomenological approach was used to identify subtle alterations linked to anomalous self-experience. RESULTS: Using the Examination of Anomalous Self-Experience symptom checklist, the case report presented here reveals attention deficit hyperactivity disorder symptoms in adolescence as a precursor state of psychosis in adulthood. CONCLUSIONS: The characteristics of this schizophrenia spectrum disorder case and its time course are derived from the specific distribution pattern of Examination of Anomalous Self-Experience items. When treating adolescent attention deficit hyperactivity disorder patients, the rare possibility of the development of schizophrenia spectrum disorder from attention deficit hyperactivity disorder like symptoms should be kept in mind.

Burnout: a fashionable diagnosis.

BACKGROUND: "Burnout syndrome" is now a common reason for medical excuses from work, and thus an important topic in health-related economics. Much research is still needed, however, to establish the scientific basis for this entity, the criteria by which it might be diagnosed and classified, and how it should be treated. METHODS: A systematic review of this topic, previously published as an HTA report, is presented here together with a selective overview of pertinent literature. RESULTS: There currently exists neither an officially accepted definition nor a valid instrument for the differential diagnosis of burnout syndrome. Its manifestations are generally considered to lie along three dimensions: emotional exhaustion, depersonalization, and reduced performance ability and/or motivation. Most of the available studies on its epidemiology and differential diagnosis provide no more than a low level of evidence for their conclusions. There have been no controlled trials of treatments for burnout. CONCLUSION: High-quality controlled studies on burnout syndrome are lacking. A standardized and internationally accepted diagnostic instrument with a validated rating scale should be developed. There is also a need for epidemiological and health-economic studies on the prevalence, incidence, and cost of burnout. The etiology and pathogenesis of burnout should be studied with special regard to the possible role of neurobiological factors. Treatments for it should be studied systematically so that their effects can be judged at a high level of evidence. In view of the current lack of knowledge about what is called "burnout," the term should not be used as a medical diagnosis or as a basis for decisions regarding disability or other socioeconomic matters.

Patterns of hydrophobicity found in the first and second transmembrane domains of solute transporters suggest a possible role in nascent protein anchoring and organization.

Solute transporters (STs) are an important subgroup of integral membrane proteins that facilitate the translocation of a diverse range of solutes such as sugars, amino acids, and neurotransmitters across cell membranes. Sequence analysis indicates that STs possess multiple stretches of hydrophobic-rich amino acids that are organized into the transmembrane domains (TMDs) of the functional protein, but exactly how the correct spatial arrangement of these domains is achieved remains a challenging problem. We hypothesized that perhaps differences in interdomain hydrophobicity might play some role in this process. To test this hypothesis, we generated a heptadic model of the alpha helix and mapped the average hydrophobicities (coaxial) and hydrophobic moments (radial) of 108 TMDs found in 9 different human ST proteins. Our results, taken together with earlier work from other groups, suggest that spatial patterns of hydrophobicity found in TMDs 1 and 2 are consistent with a role for these domains in the initial anchoring of the nascent ST protein to the endoplasmic reticulum (ER), as it emerges from the ribosome complex and perhaps in the subsequent spatial organisation of STs.

Suicide risk markers in major depressive disorder: a study of electrodermal activity and event-related potentials.

BACKGROUND: Globally approximately 1 million people die annually by suicide. We studied both Electrodermal Activity (EDA) and Event-Related Potential (ERP) P3, together with an assessment of expressed anger as potential suicide risk predictors in Major Depressive Disorder (MDD) patients. METHODS: In this controlled cross-sectional study, MDD inpatients were allocated to one of three groups: 1. history of 'hard attempted suicide' (e.g., hanging, stabbing; HAS), 2. 'soft attempted suicide' (poisoning; SAS) or 3. no attempted suicide (NAS), respectively. Patients were tested using both an auditory habituation paradigm (study 1) and an 'oddball task' (study 2). EDA Habituation Rate (HabR) and P3 amplitude differences evoked by both 'novel' and 'target' stimuli were computed between the first and second halves of the two studies. 'Anger' was assessed using State Trait Anger Expression Inventory (STAXI) subscales. RESULTS: HabRs in both HAS (n=16) and SAS (n=16) were significantly lower than in NAS (n=18), in both study 1 and study 2, condition 'novel'. Decreases in P3 were also more pronounced in the HAS and SAS groups in study 1 and in the HAS group in study 2, 'novel' and 'target' condition. STAXI Anger In score was higher in HAS than in NAS. LIMITATIONS: The sample size is small; medication may influence EDA. CONCLUSIONS: Both EDA and P3 habituated faster in MDD patients with a history of attempted suicide, and were associated with higher 'anger' scores. Our data is a starting point for developing further neurobiological assessments of suicide risk in clinical practice.

Treating auditory hallucinations by transcranial magnetic stimulation: a randomized controlled cross-over trial.

BACKGROUND: In a previous functional magnetic resonance imaging study, the authors succeeded in demonstrating the activation of Heschl's gyrus during auditory hallucinations (AH). OBJECTIVES: This study aims to treat AH specifically by repetitive transcranial magnetic stimulation (rTMS). METHODS: 16 patients with AH were included in a randomized, cross-over, sham-controlled trial. 1 Hz rTMS was administered over the left and right temporo-parietal cortex and sham position, respectively, on 5 consecutive days; 900 stimuli each, strength 100% of motor threshold. Using the Psychotic Symptom Rating Scales (PSYRATS), the hallucinations during the stimulation periods and 4-week follow-ups were quantified. Electroencephalograms (EEG) were acquired before and after each period. RESULTS: Treatment responses were observed after left hemisphere rTMS only. The 5 patients who showed a response did so already after 2 days. However, group mean hallucination scores did not differ across treatment conditions. No significant changes were found in EEG after rTMS. CONCLUSIONS: A subgroup of patients suffering from AH benefits soon after treatment start from rTMS over the left superior temporal gyrus as revealed by the decrease of AH scores compared to right-sided and sham procedures.