[Interpersonal violence in the context of affective and psychotic disorders]. / Zwischenmenschliche Gewalt im Kontext affektiver und psychotischer Störungen.

Some mental and neurobiological disorders are associated with an increased risk for violence against others. The stigmatization of people with mental illnesses essentially emerges from a distorted perception of this condition. This review article summarizes the available literature on the determinants, prevention, therapy and tools for prediction of serious interpersonal aggression in the context of people with mental disorders. The risks for violence against other people show substantial variation between the various diagnoses. Schizophrenia and mania carry a clearly increased risk particularly at the onset of the disorder but disease-specific pharmacological therapy can reduce these risks. The highest risk factors are in particular previous violence, misuse of alcohol and drugs, male gender and young age. Probabilistic predictions of subsequent aggression against others on an individual-specific basis are only feasible in enriched populations (especially persons with mental illnesses and a previous history of assaults). Valid individual-specific predictions of future violence in the general population or on the basis of diagnoses of mental illness are, however, currently not feasible with sufficient accuracy.

[The German University Medicine Map]. / Landkarte Hochschulmedizin.

The University Medicine Map is a major step towards the realization of more transparency regarding the overall services of the medical schools in research, teaching, and patient care within the German university system. It includes comparative information about all 36 medical schools in Germany for the following areas: legal framework, finance, personnel, medical research, teaching and medical education, as well as patient care. The complete set of data for this map is accessible online under www.landkarte-hochschulmedizin.de and a selection of data is also available in print. Advantages and possible political implications for the higher education sector as well as the public domain are illustrated. Finally, the perspectives for future developments are indicated.

Desulfovibrio idahonensis sp. nov., sulfate-reducing bacteria isolated from a metal(loid)-contaminated freshwater sediment.

Two novel sulfate-reducing bacteria, strains CY1T and CY2, were isolated from heavy-metal-contaminated sediments of Lake Coeur d'Alene, Idaho, USA. Strains CY1T and CY2 were found to contain c-type cytochromes and to reduce sulfate, sulfite, thiosulfate, elemental sulfur, DMSO, anthraquinone disulfonate and fumarate using lactate as an electron donor. In a comparison of 16S rRNA gene sequences, CY1T and CY2 were found to be 100% identical, but only 97 and 92.4% similar, respectively, to the type strains of Desulfovibrio mexicanus and Desulfovibrio aminophilus. Unlike these species, however, CY1T was neither able to disproportionate thiosulfate nor able to use yeast extract or amino acids as electron donors. These data, considered in conjunction with differences among strain CY1T and the two related type strains in chemotaxonomy, riboprint patterns, temperature and pH optima, support recognition of a distinct and novel species within the genus Desulfovibrio, Desulfovibrio idahonensis sp. nov., with the type strain CY1T (=DSM 15450T=JCM 14124T).

[The assessment of free volitional competence in cases of suicide with life insurance]. / Begutachtung der "freien Willensbestimmung" bei Suizid in der Lebensversicherung.

The German insurance law stipulates that in cases of suicide, life insurance providers are not obligated to pay within a restriction period of 3 years, except if it can be proven that the suicide was committed in a state that precludes the insured's ability to make free choices. The relevant psychiatric assessment criteria are identical with those of mental and volitional competence in general. However, a different profile of patients and other disorders are involved, mainly depressive syndromes, but also chronic alcoholism as well as schizophrenic and paranoid syndromes. The assessment has to be based on the legal concept of mental disorder, which is different from the current diagnostic classifications in psychiatry. Decisive psychopathological symptoms are impairment of reality control, of volition and/or of judgement. These posthumous assessments are particularly difficult and require a thorough knowledge of psychopathology as well as of the relevant jurisdiction. The latter is summarised in this article.

[Public health ethics is partnership ethics]. / Public-Health-Ethik ist Partnerschaftsethik.

Securing and safeguarding the health of citizens are preeminent governmental obligations and cultural as well as ethical responsibilities. Public health needs to be developed, implemented and reviewed in partnership with existing private and public market forces and with health-literate citizens; mission, strategy, tactics and ethics of public health depend on partnership ethics. Traditional sets of principles in bioethics, research ethics, or clinical ethics are not useful to delineate the framework, the mandate, and the specific conflicts and risks in public health. The SEMPER model exemplifies the role of the principles of safety, education, minimax, partnership, efficiency, review and their interactions for public health in securing and promoting health and quality of life.

[Ethical aspects of a pandemic influenza management and conclusions for health policy. An overview]. / Ethische Aspekte eines Influenzapandemie-managements und Schlussfolgerungen für die Gesundheitspolitik. Ein Uberblick.

Infectious diseases are among the major global health threats. Although associated with these diseases there are vast ethical challenges, ethics has more focused on other health related issues--e.g., associated with rare diseases, embryo research, genetic diagnosis. Nowadays we are facing a possible influenza pandemic caused by a new human influenza virus subtype. This article presents issues and ethical challenges of the pandemic threat. The authors argue that it is necessary to consider ethical implications of pandemic influenza preparedness early on and to include ethical reasoning when deciding on the measures for the pandemic management.

[Behavioural addiction : an independent diagnostic category?]. / Verhaltenssucht : Eine eigenständige diagnostische Einheit?

Until recently knowledge was limited with respect to clinically relevant excessive reward-seeking behaviour such as pathological gambling, excessive shopping, and excessive working which meet diagnostic criteria of dependent behaviour. To date there is no consistent concept for diagnosis or treatment of excessive reward-seeking behaviour, and its classification is uncertain. However, the high number of subjects seeking treatment emphasises the importance of a clear conceptualisation of the so-called behavioural addictions and their successful treatment. Excessive reward-seeking behaviour may be used to regulate negative emotions. We suggest that, comparable to drug addiction, excessive reward-seeking behaviour can alleviate negative mood states and may be used as an (inadequate) stress coping strategy at the expense of active coping strategies. In the course of a pathological development, behavioural addiction may become the only available behavioural resource to cope with challenging developmental steps or social stress factors such as loneliness or anxiety.

Desulfosporosinus lacus sp. nov., a sulfate-reducing bacterium isolated from pristine freshwater lake sediments.

A novel sulfate-reducing bacterium was isolated from pristine sediments of Lake Stechlin, Germany. This strain, STP12(T), was found to contain predominantly c-type cytochromes and to reduce sulfate, sulfite and thiosulfate using lactate as an electron donor. Although STP12(T) could not utilize elemental sulfur as an electron acceptor, it could support growth by dissimilatory Fe(III) reduction. In a comparison of 16S rRNA gene sequences, STP12(T) was 96.7 % similar to Desulfosporosinus auripigmenti DSM 13351(T), 96.5 % similar to Desulfosporosinus meridiei DSM 13257(T) and 96.4 % similar to Desulfosporosinus orientis DSM 765(T). DNA-DNA hybridization experiments revealed that strain STP12(T) shows only 32 % reassociation with the type strain of the type species of the genus, D. orientis DSM 765(T). These data, considered in conjunction with strain-specific differences in heavy metal tolerance, cell-wall chemotaxonomy and riboprint patterns, support recognition of strain STP12(T) (=DSM 15449(T)=JCM 12239(T)) as the type strain of a distinct and novel species within the genus Desulfosporosinus, Desulfosporosinus lacus sp. nov.

[Cognitive impairment after accidental high-dose corticosteroid therapy]. / Kognitive Störungen nach akzidenteller hoch dosierter Kortisontherapie.

Synthetic glucocorticosteroids can induce various severe mental disorders. Persisting cognitive disorder represents a rare complication of corticoid therapy involving memory, concentration, attention, or occupational performance. We observed the effects of a 20-day self-induced high-dose corticosteroid treatment on the cognitive functions in a 54-year-old patient. Having excluded dementia due to other organic causes, we examined the patient neuropsychologically immediately at the end of the steroid therapy and at follow-up (1, 2, 4, and 6 months). The initial tests showed seriously impaired functioning of concentration, attention, learning, and memory as well as of common ability to solve problems. The follow-up tests up to 6 months revealed an improvement of concentration and attention, but there were still serious deficits of the declarative memory with a high confabulating tendency. Our results confirm those of human experimental studies that exogenous steroids can cause serious persisting specific cognitive disorders especially of the declarative, hippocampus-dependent memory.

[Regulation on preventive detention according to section sign 66 of the German Penal Code. Principles and differential indication compared with the regulation according to section sign 63 of the German Penal code]. / Massregel der Sicherungsverwahrung nach (section sign) 66 StGBGrundlagen und Differenzialindikation gegenüber der Massregel gemäss (section sign) 63 StGB.

Preventive detention is imposed by court order if a dangerous criminal shows a disposition to relapse. The negative criminal prognosis should be given by a psychiatric expert based on considerations about the criminal's personality traits. Matters of preventive detention are important for forensic psychiatry, but so far have rarely been discussed. This article presents related problems and offers-under special consideration of problematic personality traits or personality disorders-practical guidelines for expert testimony. Our considerations should serve as a thought-provoking stimulus for further psychiatric discussions about this topic.

[Personality disorders and schizophrenic psychoses]. / Persönlichkeitsauffälligkeiten und schizophrene Psychose.

We analysed two aspects of personality abnormality detected before the disorder became diagnostically apparent: potential genetic disposition, assessed using family and adoption studies, and premorbid constitution, which we outlined using retrospective and prospective studies. Current continuum models of the schizophrenic spectrum suggest that genetic disposition and premorbid constitution overlap to some extent, an area which ought to be better defined psychopathologically. In this overview, we determined a group of symptoms-bizarre behaviour, alogia, social withdrawal, and subclinical thought disorders-which are relevant for both schizotypal personality disorders and early schizophrenia. The topic of so-called reactive psychoses is examined to find an interface between personality abnormality and psychosis.

Affective disorders, personality and personality disorders.

OBJECTIVE: The article deals with the complex conceptual history and current concepts on the relationship between personality, personality disorders and affective disorders. It is discussed whether these concepts represent distinct clinical entities or whether they lie on a continuum. METHOD: We reviewed the classical literature from the 19th and the first half of the 20th centuries as well as analysed recent empirical data in order to summarize the current knowledge on this topic with respect to its historical origin. As a particular example, the position of the depressive personality disorder is evaluated. RESULTS: Considerable heterogeneity can be seen, both theoretically and empirically. The two major concepts are based either on a continuum model or favour distinct clinical entities, corresponding to a more dimensional or category-orientated recording method. CONCLUSION: The relationship between personality disorders and affective disorders is still unclear and is a highly debated issue. There is as yet no consensus, but a certain shift to dimensional models can be recognized.